title: Effects of dexmedetomidine on smooth emergence from anaesthesia in elderly patients undergoing orthopaedic surgery.
abstract: BACKGROUND
  Intraoperative dexmedetomidine may decrease postoperative emergence agitation in elderly patients due to its sedative effect. In this study, we evaluated the effect of adjuvant dexmedetomidine on smooth emergence from anaesthesia after orthopaedic surgery in elderly patients.
  
  
  METHODS
  A total 115 patients (ASA I-II, aged over 65 years) were randomly allocated into four groups. Anaesthesia was maintained with either sevoflurane or total intravenous anaesthesia (TIVA) comprising propofol and remifentanil. Patients were also administered either dexmedetomidine (0.4 μg kg(-1) hr(-1); SD and TD) intraoperatively or normal saline (SN or TN) as a control. The bispectral index (BIS) score was maintained from 40-60 intraoperatively. All anaesthetics and dexmedetomidine were discontinued at surgical conclusion, and the recovery times (durations to a BIS = 60, 70, and 80; eye opening; and extubation) were measured. The mean arterial pressure, heart rate, Ricker's agitation-sedation scale (RSAS), visual analogue scale (VAS) for pain, and incidences of emergence agitation and postoperative nausea and vomiting (PONV) were measured in the recovery room.
  
  
  RESULTS
  Dexmedetomidine significantly decreased the RSAS score in the SD and TD groups, and a calm state postoperatively occurred more frequently in these groups than in the control groups. The heart rate and incidence of emergence agitation were lower in the dexmedetomidine groups. Recovery time was higher in the SD group than in the SN group, and no significant differences occurred between the TN and TD groups. The VAS score was lower in the SD group than in the SN group, and the PONV did not differ regardless of the use of dexmedetomidine.
  
  
  CONCLUSIONS
  Dexmedetomidine may be an effective intraoperative adjuvant for a reducing emergence agitation and smooth emergence from anaesthesia after orthopaedic surgery in elderly patients.
  
  
  BACKGROUND
  Current Controlled Trials NCT01851005 .
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, South Korea. mypigfarm@naver.com.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, South Korea. ksh3223@chosun.ac.kr.
authors.forename: Sang Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, South Korea. kyso@chosun.ac.kr.
authors.forename: Keum Young
authors.initials: KY
authors.lastname: So
authors.affiliation: Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, South Korea. mdmole@chosun.ac.kr.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Jung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine