2026· Asian Journal of Medical Research and Health Sciences· Vol 04, pp. 1759-1764· 0 citations
TL;DR
Dexmedetomidine is an effective intraoperative adjuvant in reducing emergence agitation and improving recovery quality in patients undergoing oral and nasal surgeries under general anaesthesia.
Abstract
Background:Emergence agitation (EA) is a postoperative complication characterized by confusion,disorientation, and restlessness during recovery from general anaesthesia. It is morecommonly observed in ENT surgeries, particularly oral and nasal procedures, due to airway discomfort and rapid emergence from volatile anaesthetics. Dexmedetomidine, an alpha-2 adrenergic agonist, has been widely studied for its sedative, anxiolytic, and sympatholytic properties in reducing EA.Methodology:This prospective randomized comparative study was conducted in the Department ofAnaesthesiology, Sree Mookambika Institute of Medical Sciences, Kulasekharam, from February 2025 to January 2026. A total of 100 patients aged 20–60 years, ASA I–II,undergoing elective oral and nasal surgeries under general anaesthesia were included and randomly allocated into two groups of50 each. Group D received dexmedetomidineintraoperatively, while Group C received standard anaesthetic management. Demographic variables, haemodynamic parameters, and incidence of emergence agitation were recorded and analysed using appropriate statistical tests.Both groups were comparable in age and gender distribution (p>0.05). Group D showedbetter haemodynamic stability and significantly reduced emergence agitation compared to Group C. Patients receiving dexmedetomidine had smoother extubation, improved sedation profiles, and lower postoperative agitation scores without significant respiratory depression.Conclusion:Dexmedetomidine is an effective intraoperative adjuvant in reducing emergence agitation and improving recovery quality in patients undergoing oral and nasal surgeries undergeneral anaesthesia.
Background:Emergence agitation (EA) is a common and distressing complication following sevoflurane anaesthesia in paediatric patients, characterized by non-purposeful restlessness, crying, and disorientation. Dexmedetomidine, a highly selective α2-agonist, is frequently utilized to prevent EA. However, the optimal administration method, rapid intravenous bolus versus continuous intraoperative infusion, remains debated regarding the balance of efficacy and hemodynamic stability.Aims and Objectives:To systematically compare the clinical effectiveness, postoperative recovery profile, and perioperative hemodynamic stability of a rapid bolus versus a continuous low-dose infusion of dexmedetomidine (0.3 μg/kg) in preventing emergence agitation in children undergoing elective abdominal and genitourinary surgeries under sevoflurane anaesthesia.Materials and Methods:This prospective, randomized, double-blind, comparative study enrolled 80 paediatric patients (ASA physical status I–II, aged 2–12 years) randomly allocated into two equal groups (n=40). Group B received IV dexmedetomidine 0.3 μg/kg as a bolus over 10 minutes; Group I received a continuous infusion at 0.3 μg/kg/hour. Intraoperative Heart Rate and MAP were continuously monitored. Postoperative emergence agitation and pain were assessed using the PAED scale and Observational Pain Scores (OPS) in the PACU.Results:Both techniques provided comparable hemodynamic stability. A transient, statistically significant decrease in MAP (p=0.015) was noted at 10 minutes post dexmedetomidine administration in group B, accompanied by a mild, non significant reduction in heart rate (p=0.184); all values remained within 20% of pre-induction baselines without requiring intervention. Group B demonstrated superior early analgesia (OPSon PACU arrival: 1.8 ± 1.2 vs 4.6 ± 1.8; p<0.001). Extubation times (6.2 ± 1.1 vs 6.5 ± 1.4 min; p=0.284) and emergence times (8.1 ± 1.5 vs 8.4 ± 1.8 min; p=0.418) were highly comparable.Conclusion:A 0.3 μg/kg bolus of dexmedetomidine is hemodynamicallysafe and clinically superior to an equivalent continuous infusion. It provides good early postoperative analgesia and effectively mitigates sevoflurane-induced emergence agitation without extending recovery or extubation times.
Sardar Bhagat Singh, Manmohan Jindal, Namrata Jain et al.· Asian Journal of Medical Res...· 0 citations
Dexmedetomidine was found to be a superior adjuvant to epidural bupivacaine compared to clonidine due to better sedation, prolonged postoperative analgesia, and effectivehaemodynamic stability with manageable adverse effects.
Dr. Mahilamani, Dr. Vijay Balan.P· Asian Journal of Medical Res...· 0 citations
Objectives: The objective of the study was to assess the effectiveness and safety of dexmedetomidine versus midazolam for sedation during regional anesthesia surgery.
Methods: This prospective randomized comparative interventional study was conducted in the Department of Anesthesiology at a tertiary care hospital from January 2025 to January 2026. 100 adult patients undergoing elective surgeries under regional anesthesia were randomly divided into two groups: Group D (dexmedetomidine, n=50) and Group M (midazolam, n=50). Richmond agitation sedation scale (RASS) was used to evaluate sedation. Intraoperative monitoring of hemodynamic parameters, such as mean arterial pressure and heart rate, was performed. Recovery characteristics, patient satisfaction, requirement for rescue sedation and adverse effects were also assessed.
Results: The mean intraoperative RASS score was significantly lower in the Group D than in the Group M (−2.8±0.5 vs. −2.5±0.7; p=0.02). The time required to reach the target sedation level was significantly greater in Group D (9.4±2.6 min vs. 7.8±2.4 min; p=0.003). The scores of patient satisfaction with dexmedetomidine use were significantly greater than with midazolam use (8.5±1.0 vs. 7.9±1.2; p=0.01). Dexmedetomidine was associated with more adverse effects of bradycardia (p=0.08) and hypotension (p=0.46), whereas midazolam was associated with more adverse effects of excessive sedation (p=0.14) and restlessness (p=0.09).
Conclusion: Dexmedetomidine and midazolam were both found to be effective sedatives for patients undergoing regional anesthetic. Dexmedetomidine was found to be a more effective sedative, well tolerated, more patient-satisfying and more stable for intraoperative hemodynamic despite its comparatively slower onset of sedation than midazolam.
AVINASH KAREKAL, SRINIVAS KURAHATTI, Rashmi C· Asian Journal of Pharmaceuti...· 0 citations
Both agents are effective for short procedural sedation, whereas propofol ensures faster recovery, and Dexmedetomidine offers superior cardiorespiratory stability, whereas propofol ensures faster recovery.
Vikash Gaurav· International Journal of Pha...· 0 citations
Background:Ambulatory anaesthesiahas become an important component of modern surgical practice due to rapid recovery, early discharge, reduced hospital stay, and improved patient satisfaction. Propofol and sevoflurane are commonly used anaesthetic agents for day-care surgeries because oftheir favourable pharmacological properties. The present study was conducted to compare the induction and recovery characteristics of propofol and sevoflurane in adult patients undergoing day-care tonsillectomy.Methodology:This randomized prospective study was conducted in the Department of Anaesthesiology, Sree Mookambika Institute of Medical Sciences, Kulasekharam, from January 2025 to December 2025. Eighty patients aged between 13 and 40 years belonging to ASA physical status I and II undergoing elective tonsillectomy and adenoidectomy were included in the study. Patients were randomly allocated into two groups of 40 each. Group P received propofol for induction and maintenance of anaesthesia, while Group S received sevoflurane. Haemodynamic parameters, induction characteristics, Phase I and Phase II recovery profiles, and postoperative complications were assessed and compared.Results:The distribution of Mallampati classification between the two groups was statistically comparable (p=0.28). Mean arterial pressure values were generally lower in the propofol group at all observed time intervals; however, the differences were not statistically significant. The Phase I recovery profile showed no statistically significant difference between Group P and Group S (p=0.29). Similarly, the Phase II recovery profile was also statistically comparable between the groups (p=0.19). Both anaesthetic agents provided satisfactory induction, stable intraoperative conditions, and rapid recovery suitable for ambulatory surgery.Conclusion:Both propofol and sevoflurane were found to be safe and effective anaesthetic agents for day-care adult tonsillectomy. The induction characteristics, haemodynamic responses, and recovery profiles were comparable between the two groups. Hence, both agents can be effectively used in ambulatory tonsillectomy procedures depending on clinical preference and patient suitability.
S. T. Priyadarshan, Balakrishnan· Asian Journal of Medical Res...· 0 citations
