Assessment of effect of two different doses of dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery

Abstract

: To evaluate two different doses of dexmedetomidine infusion on emergence agitation and measurement of hemodynamics, bispectral index, cortisol levels, and quality of recovery in patients who underwent nasal surgery under general anaesthesia.94 individuals of either sex between the ages of 18 and 65 who experienced nasal surgery under general anesthesia were split into two groups for this randomized experimental study. Before induction, each group received loading doses of dexmedetomidine (DEX) infusion at a rate of 1 µg/kg over a period of 10 minutes. Group B underwent a standard induction and then received an infusion of 0.4μg/kg/h of dexmedetomidine every hour until they were extubated, while group A received an infusion of 0.8μg/kg/h. Sevoflurane was employed for maintenance. During emergence, the frequency of agitation, cough hemodynamic parameters, and recovery traits were assessed. Patients received the Quality of Recovery (QoR-40) questionnaire 24 hours following surgery.The hemodynamic reaction to laryngoscopy and intubation was blunted and the intubating circumstances were improved by both doses equally well. Group A's intraoperative mean PR and MAP were significantly (P<0.05) lower than group B's. Coughing was more common among the subjects in group A. A statistically significant difference was found between groups in comparing emergence agitation. Cortisol levels were significantly higher postoperatively in the 0.4µg/kg dose of dexmedetomidine 0.8µg/kg/ group (p=0.001). Global QoR-40 score at 24 h after surgery showed a better global recovery profile in group A. :Although a greater dose of DEX may have more hemodynamic adverse effects, it may also reduce the incidence of emergent agitation, the surgical stress response, and a smoother recovery profile.