Role of dexmedetomidine infusion on post operative emergence agitation and quality of recovery after nasal surgery: A prospective randomized double blind controlled trial

Abstract

Study aims to reduce the emergence agitation post operatively and improve the quality of recovery after nasal surgery which in-turn reduce the hospital stay and in-hospital mortality. Settings and Design: Prospective, randomized, double blind study Material and Methods: After institutional review board approval and informed written consent from patients, seventy patients undergoing nasal surgery were selected & randomized into two groups. The dexmedetomidine group (Group D, n=35) received dexmedetomidine infusion @ rate of 0.4 µg/kg/hr from induction of anaesthesia until extubation, while the control group (Group C, n=35) received volumematched normal saline infusion as placebo. Induction of anaesthesia was done using Propofol (2 mg/kg) and fentanyl (1 µg/kg). Maintainance of anaesthesia was done using inhalational sevoflurane & inj.vecuronium. The incidence of agitation, haemodynamic parameters, and recovery characteristics were evaluated during emergence. Patients were assessed for quality of recovery using a 15-item quality-of-recovery questionnaire (QoR-15) 24 hr after surgery. Statistical Analysis: Data were analysed by using unpaired t -test, Chi-square test. Results: The incidence of agitation was lower in group D than group C(22.8% vs 51%). HR and MAP were comparable in group D & group C. Extubation time & grade of cough during emergence were similar between the groups. QoR-15 score was significantly more in group D compare to group C at 24 hour after surgery. Conclusions: Intraoperative infusion of dexmedetomidine decreased incidence of agitation & improved quality of recovery after nasal surgery.