Online ISSN: 2515-8260

Keywords : Emergence Agitation

Efficacy Of Intraoperative Dexmedetomidine Infusion on Emergence Agitation and Quality of Recovery after Functional Endoscopic Sinus Surgery

Dr. Puspanjali Jena, Dr. Sudarshini M., Dr. Shashwathi Siddaramappa

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 602-609

Background: Emergence agitation has potential to harm both patients and caregivers. This is more often witnessed in patient undergoing otolaryngology operations under general anesthesia with volatile anesthetic used for maintenance.
Aim: We investigated the effects of intra-operative dexmedetomidine infusion on emergence agitation and quality of recovery after functional endoscopic sinus surgery in adult patients.
Materials and Methods: One hundred patients undergoing functional endoscopic sinus surgery were randomized into two groups. The dexmedetomidine group (Group D, n = 50) received dexmedetomidine infusion at a rate of 0.4 mcg/kg/hr from induction of anaesthesia until extubation, while the control group (Group C, n = 50) received volume-matched normal saline infusion as placebo. Propofol (2 mg/kg) and fentanyl (2 mcg/kg) were used for induction of anaesthesia, and sevoflurane was used for maintenance of anaesthesia. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated during emergence. A 40-item quality-of-recovery questionnaire (QoR-40) was provided to patients 24 hours after surgery.
Results: The incidence of agitation was lower in Group D than Group C (28 vs 56 %, P = 0.018). Mean arterial pressure and heart rate were more stable intra-operatively and during emergence in Group D than in Group C (P < 0.05). Time to extubation, nausea and vomiting, and pain scores were similar between the groups. Global QoR-40 score at 24 hours after surgery was higher in Group D (mean 174.7 ± 6.99) compared with Group C (mean 169.4 ± 9.91) (P < 0.05).
Conclusion: Intra-operative infusion of dexmedetomidine provided smooth and hemodynamically stable emergence. It also improved quality of recovery after nasal surgery.

Effects of Intravenous Dexmedetomidine and Fentanyl on Emergence Characteristics in Adult Patients Undergoing Laparoscopic Surgeries

Dr. Rishindra Babu, Dr. Bonasi Devender, Dr. Lokesh Walvekar

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 3, Pages 1568-1574

Emergence agitation (EA) presents clinically as disorientation, restlessness, excitation, inconsolability, unnecessary movement, incoherence and thrashing during the initial recovery from general anesthesia. Beneficial effects of dexmedetomidine (DEX) against emergence agitation (EA) in adults remain controversial.
Aim and Objective : To compare the effects  of Dexmedetomidine and Fentanyl on emergence delirium and quality of recovery from general anaesthesia after laparoscopic surgeries. Material and Method : This was the Hospital based prospective, randomized double blind clinical trial. conducted on patients receiving IV dexmedetomidine versus IV Fentanyl among Patients undergoing laparoscopic surgeries under general anaesthesia. A Total 100 patients, allocated to two groups of 50 each (n=50), after following inclusion and exclusion criteria and getting informed consent form patients. p-value<0.01 was statistically significant.
Results: Mean difference between the group for age,  Time duration at PACU, Duration of Surgery was assessed by using t-test, and difference in the proportion between the groups were assessed by using chi-square test for proportions. p-value less than 0.05 was consider statistically significant at 5% level of significance.time taken for verbal response was statically significant between the groups and this time was more  in group D compared to Group F, also PACU stay was statistically significant and more time was taken in group D. Riker Sedation-Agitation Scale between the groups and we had more patients observed calm and cooperative in group D but in group F we have observed patients with agitated to dangerous agitation. Conclusion: Premedication with dexmedetomidine 1mcg/kg intravenously provides better quality and haemodynamic of extubation and reduces emergence agiation compared to fentanyl 1mcg/kg in adults undergoing laparoscopic surgeries.