title: Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery.
abstract: BACKGROUND
  Emergence agitation is common after nasal surgery. We investigated the effects of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery in adult patients.
  
  
  METHODS
  One hundred patients undergoing nasal surgery were randomized into two groups. The dexmedetomidine group (Group D, n=50) received dexmedetomidine infusion at a rate of 0.4 μg kg(-1) h(-1) from induction of anaesthesia until extubation, while the control group (Group C, n=50) received volume-matched normal saline infusion as placebo. Propofol (1.5-2 mg kg(-1)) and fentanyl (1 μg kg(-1)) were used for induction of anaesthesia, and desflurane 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 h after surgery.
  
  
  RESULTS
  The incidence of agitation was lower in Group D than Group C (28 vs 52%, P=0.014). Mean arterial pressure and heart rate were more stable in Group D than in Group C during emergence (P<0.05). Time to extubation, bispectral index, and respiratory rate at extubation were similar between the groups. Global QoR-40 score at 24 h after surgery was higher in Group D (median [range], 183 [146 -198]) compared with Group C (178 [133-196]) (P=0.041).
  
  
  CONCLUSIONS
  Intraoperative infusion of dexmedetomidine provided smooth and haemodynamically stable emergence. It also improved quality of recovery after nasal surgery.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: B M
authors.initials: BM
authors.lastname: Song
authors.forename: B N
authors.initials: BN
authors.lastname: Koo
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D001794:Blood Pressure / Q000187:drug effects; D020927:Dexmedetomidine / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059747:Nasal Surgical Procedures; D011595:Psychomotor Agitation / Q000453:epidemiology*; D012965:Sodium Chloride / Q000008:administration & dosage; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D012965:Sodium Chloride; D020927:Dexmedetomidine
keywords: anaesthesia, general; complications, extubation trachea; pharmacology, dexmedetomidine; recovery, postoperative