Abstract

Objective: Emergence agitation (EA) is defined as a transient condition in which emergence from general anesthesia is accompanied by psychomotor agitation. Dexmedetomidine (Dex) is known to reduce EA in children. The objective of this study was to determine the effects of intraoperative Dex on EA undergoing closed reduction of a nasal bone fracture.
Methodology: Thirty-eight male patients, ages 18 to 60 years, were randomized to receive a single intraoperative dose of Dex 1.0 µg/kg (Group D) or the same volume as normal saline (Group N) over 5 minutes before endotracheal intubation. The Richmond agitation sedation scale (RASS) was utilized to assess the intensity of the EA.
Results: EA was observed in 12 patients in group D compared with 18 patients in group N (P=0.042). Heart rate was significantly lower one minute after intubation (P=0.032), one minute before extubation (P=0.023), and upon arrival in the PACU (P=0.013). The mean blood pressure was lower one minute after extubation (P=0.004). Postoperative pain was significantly less in group D (P=0.050).
Conclusion: A single intraoperative dose of Dex was an effective method to reduce EA in adult patients undergoing closed reduction for a nasal bone fracture.

Key words: Dexmedetomidine, emergence agitation, general anesthesia, nasal bone fracture, Richmond agitation sedation scale