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Efficacy of Intraoperative Dexmedetomidine on Emergence from Anesthesia and on Recovery Characteristics after FESS (Functional Endoscopic Sinus Surgery)

Ram Kiran KS , Ram Kiran KS1 , Saadat Ali Khan2 , Rakesh R3

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Indian Journal of Anesthesia and Analgesia 6(3):p 973-980, May-June 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.40

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Ram Kiran KS, Saadat Ali Khan, Rakesh R. Efficacy of Intraoperative Dexmedetomidine on Emergence from Anesthesia and on Recovery Characteristics after FESS (Functional Endoscopic Sinus Surgery). Indian J Anesth Analg. 2019;6(3):973-980.

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Abstract

Context: Emergence agitation is a post anesthetic phenomenon commonly associated with ENT surgeries. We studied the effects of maintenance infusion of Dexmedetomidine on prevention of Emergence agitation in adult patients undergoing FESS. Aims: To see the effects of intraoperative dexmedetomidine infusion on incidence of emergence agitation and recovery characteristics in terms of cough, pain and nausea vomiting scores. Settings and Design: A prospective, randomized, controlled, double blinded comparative study done at our institute. Methods and Material: One hundred patients undergoing FESS surgery were randomized into two groups. Group D (n=50) received dexmedetomidine infusion at a rate of 0.5 μg kg−1 hr−1 from induction of anesthesia until extubation, while group C (n=50) received volume-matched normal saline infusion. The incidence of agitation and recovery characteristics in terms of Cough score, Nausea vomiting score and Pain scores were evaluated in both groups. Statistical analysis used: Parametric data were analyzed using oneway ANOVA and the Student’s paired t-test where appropriate. Non parametric data were analyzed using Chi-square test. A value of p < 0.05 was considered statistically signicant. Results: The incidence of Emergence Agitation (Ricker sedation agitation score ≥ 5) was higher in group C compared to group D (p <0.001). Recovery characteristics in terms of Cough score (p=0.118) and Nausea vomiting score (p=0.589) were similar in both groups, while Pain score was higher in Group C compared to Group D (p<0.001). Increase in Heart rate and MAP at emergence was more in Group C compared to Group D. Conclusions: Dexmedetomidine as an adjuvant to general anesthesia for FESS is an excellent drug to reduce Emergence agitation, provide better postoperative pain relief and also maintains stable hemodynamics at emergence.

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Ram Kiran KS, Saadat Ali Khan, Rakesh R. Efficacy of Intraoperative Dexmedetomidine on Emergence from Anesthesia and on Recovery Characteristics after FESS (Functional Endoscopic Sinus Surgery). Indian J Anesth Analg. 2019;6(3):973-980.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.40

Keywords

Dexmedetomidine; Emergence agitation; Nasal surgery.

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