Efficacy of dexmedetomidine for prevention of emergence agitation in patients posted for nasal surgery under desflurane anaesthesia: A prospective double-blinded randomised controlled trial

Garg, Akaansha; Kamal, Manoj; Mohammed, Sadik; Singariya, Geeta; Chouhan, Dilip Singh; Biyani, Ghansham

doi:10.4103/ija.ija_788_17

Cited by 24 publications

(27 citation statements)

References 21 publications

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“…Sympatholytic property of dexmedetomidine provided lower systolic blood pressure during T1 min to T15 min of operation. Our finding was in accordance with studies that found a significant reduction in hemodynamic status using dexmedetomidine ( 19 , 20 ). Also, Jae-Wook et al ( 21 ) demonstrated that dexmedetomidine has sympatholytic effects and it is used for sedative, anxiolytic, and analgesic purposes as an adjunct to several anesthetics.…”

Section: Discussionsupporting

confidence: 93%

“…One of the most common problems in the recovery ward is delayed recovery and longer discharge time of patients receiving pre-operative or intra-operative dexmedetomidine infusion. ( 19 , 21 , 22 ) In our research, the duration of the recovery ward stay was significantly longer in the DA group than in the KA group. However, two groups were similar in terms of total anesthesia time and awakening time.…”

Section: Discussionmentioning

confidence: 43%

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Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

et al. 2020

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Objectives: To compare the sedative effects of dexmedetomidine alfentanil versus ketamine-alfentanil in patients undergoing closed reduction of nasal fractures on the basis of intraoperative hemodynamic changes, satisfaction of patients and surgeons, and the adverse effects. Methods: Sixty patients with ASA class 1 or 2 were randomized to either of two groups, a dexmedetomidine alfentanil group (DA group; n = 30) or a ketamine-alfentanil group (KA group; n = 30). Hemodynamic parameters, oxygenation status, adverse events, the satisfaction of patients and surgeons, and postoperative pain scores by visual analog scale (VAS) were recorded at specific time intervals during the trial. Results: Systolic blood pressure was significantly lower in the DA group than in the KA group from T1 min to T15 min. The duration of the recovery ward stay was longer in the DA group; however, two groups were similar in terms of total anesthesia time and awakening time. Likewise, two groups were similar in terms of the patient and surgeon’s satisfaction, pain scores, and the occurrence of adverse effects. Conclusions: Both sedation methods were safely performed, and dexmedetomidine-alfentanil is as effective as ketamine-alfentanil in patients undergoing short-term operations such as nasal fracture corrections.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 43%

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

et al. 2020

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“…In elderly patients admitted to the ICU, dexmedetomidine contributes to improved sleep quality pattern, reduced delirium, increased survival up to 2 years, and improved cognitive function and quality of life in 3-year survivors 25–27. Likewise, its intraoperative use has increased because it could reduce EA in pediatric patients after general anesthesia28 or in adults undergoing nasal surgery 9,11,12. However, evidence regarding the effects of dexmedetomidine on EA and recovery quality in adults after lung surgery is still lacking.…”

Section: Discussionmentioning

confidence: 99%

<p>Intraoperative dexmedetomidine infusion is associated with reduced emergence agitation and improved recovery profiles after lung surgery: a retrospective cohort study</p>

Kang

Tang

et al. 2019

DDDT

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This retrospective cohort study aimed to investigate the association between intraoperative dexmedetomidine infusion and emergence agitation (EA), and recovery profiles after lung surgery in adult patients. It was hypothesized that dexmedetomidine was associated with reduced EA and improved recovery profiles. Patients and methods: A single-center chart review was conducted on elective lung surgeries in adults between January and December 2016. The primary outcome was the incidence of EA in postanesthesia care units (PACUs). The secondary outcomes included rescue analgesia, shivering, time to extubation, residual sedation, postoperative pulmonary events, duration of PACU stay, length of hospital stay, and intraoperative hemodynamic changes. Univariate and multivariate regression analyses were used to analyze data. Results: Among 2,468 patients, 814 received an intraoperative dexmedetomidine infusion. Intraoperative dexmedetomidine infusion was associated with a lower incidence of EA (10.9% vs 15.0%; adjusted OR, 0.67; 95% CI, 0.51-0.87; P=0.003), rescue analgesia (7.6% vs 12.2%; adjusted OR, 0.63; 95% CI, 0.47-0.86; P=0.003), shivering (4.2% vs 6.6%; adjusted OR, 0.58; 95% CI, 0.38-0.88; P=0.010), and intraoperative bradycardia (18.6% vs 12.6%; adjusted OR, 1.51; 95% CI, 1.19-1.92; P=0.001). No differences were observed in residual sedation, duration of PACU stay, postoperative pulmonary events, and length of hospital stay between the groups. Conclusion: This retrospective study suggested that intraoperative dexmedetomidine infusion was associated with a lower incidence of EA, rescue analgesia, and shivering in adults after lung surgery. Intraoperative bradycardia was the main side effect.

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“…Several studies have advocated the beneficial effects of intraoperative administration of dexmedetomidine for reducing the incidence of perioperative morbidities after nasal surgery, such as intraoperative bleeding, postoperative pain, and EA [13, 18, 19]. Considering the short length of CR surgery, an intraoperative infusion of dexmedetomidine as an anesthetic adjuvant may prolong the anesthesia and recovery time [20]. Previous studies have shown that a single -dose of dexmedetomidine, not as a premedication, is also effective in reducing EA and facilitating smooth extubation after pediatric adenotonsillectomy [10].…”

Section: Discussionmentioning

confidence: 99%

Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial

Kim

Kwak

et al. 2019

BMC Anesthesiol

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Background Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures. Methods In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group ( n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 μ/kg over 10 min, pre-operatively). The primary endpoint was Aono’s four-point scale scores after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints. Results Aono’s four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1] vs. 1 [1, 2], 95% confidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group. Conclusions Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery. Trial registration Identifier: KCT0000585 (registration date: 12–19- 2012).

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Efficacy of dexmedetomidine for prevention of emergence agitation in patients posted for nasal surgery under desflurane anaesthesia: A prospective double-blinded randomised controlled trial

Cited by 24 publications

References 21 publications

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

<p>Intraoperative dexmedetomidine infusion is associated with reduced emergence agitation and improved recovery profiles after lung surgery: a retrospective cohort study</p>

Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial

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