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Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery

 S. Y. Kim  ;  J. M. Kim  ;  J. H. Lee  ;  B. M. Song  ;  B. N. Koo 
 BRITISH JOURNAL OF ANAESTHESIA, Vol.111(2) : 222-228, 2013 
Journal Title
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Adult ; Anesthesia Recovery Period* ; Blood Pressure/drug effects ; Dexmedetomidine/pharmacology* ; Double-Blind Method ; Female ; Heart Rate/drug effects ; Humans ; Hypnotics and Sedatives/pharmacology* ; Incidence ; Intraoperative Care/methods* ; Male ; Middle Aged ; Nasal Surgical Procedures* ; Psychomotor Agitation/epidemiology* ; Sodium Chloride/administration & dosage ; Treatment Outcome ; Young Adult
anaesthesia ; general ; complications ; extubation trachea ; pharmacology ; dexmedetomidine ; recovery ; postoperative
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.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
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