Effect of intraoperative iv dexmedetomidine on emergence agitation after sevoflurane anaesthesia in children undergoing tonsillectomy with or without adenoidectomy

Introduction: Sevoflurane, a popular inhalational anaesthetic agent for paediatric anaesthesia is associated with high incidence of emergence agitation (up to 80%). This study aims to evaluate the effects of intraoperative dexmedetomidine on incidence and severity of emergence agitation (EA) in children after tonsillectomy with or without adenoidectomy under sevoflurane anaesthesia. Materials and Methods: This prospective, randomized double blind study included 70 patients aged 2-10 years with ASA physical status I and II who were randomly allocated into two groups. Group D (n = 35) received intravenous dexmedetomidine 0.3 µg/kg and Group C (n = 35) received normal saline, both given post intubation over 10 min. After extubation, emergence agitation (EA) was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) score, the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for evaluating postoperative pain and modified Aldrete score for PACU discharge time were noted. Results: Demographic profile was comparable between two groups. Incidence of emergence agitation was significantly less in Group D than Group C (20% vs 42.86%). Postoperative pain was significantly less in Group D in comparison of Group C (14.3% vs 37.15%). Emergence time, extubation time and PACU discharge time were significantly longer in Group D in comparison to Group C (8.1 ± 1.4 vs 7.1 ± 1.4 min, 9.06 ± 1.59 vs 8.06 ± 1.39 min and 23.1 ± 7.6 vs 18.1 ± 8.2 min respectively). No complications were observed between two groups except vomiting. Conclusion: Dexmedetomidine 0.3 µg/kg) given intravenously just after intubation may be considered as an effective drug to reduce emergence agitation after sevoflurane anaesthesia in children undergoing tonsillectomy with or without adenoidectomy. Keywords: Dexmedetomidine, Intraoperative, Emergence agitation, Sevoflurane, Tonsillectomy.