2 research outputs found
Comparison between dexmedetomidine and remifentanil infusion in emergence agitation during recovery after nasal surgery
Background. Postoperative emergency agitation (EA) is a common problem.
Dexmedetomidine and remifentanil may be used to prevent this problem.
Our primary aim was to compare dexmedetomidine, remifentanil, and
placebo with respect to their effectiveness in preventing postoperative
EA.
Material and methods. Ninety patients undergoing nasal surgery were
randomized into three groups. The dexmedetomidine group (group D, n =
30) received dexmedetomidine infusion at a rate of 0.4 mu g kg(-1)
h(-1); the remifentanil group (group R, n = 30) received remifentanil
infusion at a rate of 0.05 mu g kg(-1) min(-1) from induction of
anesthesia until extubation; and the control group (group S, n = 30)
received a volume-matched normal saline infusion as a placebo. Propofol
(1.5-2 mg kg(-1)) and fentanyl (1 mu g kg(-1)) were used to initiate
anesthesia, and desflurane was used to maintain anesthesia. The
incidence of agitation, hemodynamic parameters, and recovery
characteristics were evaluated during emergence.
Results. The incidence of EA was significantly higher in group S (46.7
\%) compared with groups R and D (3.3 and 20 \%, respectively; p <
0.001). The lowest incidence of EA was detected in group R (p = 0.046).
Residual sedation in the post-anesthesia care unit (PACU) was similar in
all groups (p = 0.947). The incidence of nausea or vomiting was
significantly lower in group D than in groups R and S (p = 0.043).
Administration of analgesics in the PACU was higher in group R than in
groups S and D (p = 0.015).
Conclusion. Anesthetic maintenance with either remifentanil or
dexmedetomidine infusion until extubation provided a more smooth and
hemodynamically stable emergence, without complications after nasal
surgery. While remifentanil was superior to dexmedetomidine with regard
to avoiding EA, dexmedetomidine was more effective than remifentanil
regarding vomiting and pain