Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery

Abstract Background Emergence agitation is a potentially serious post-anesthetic event occurring in the early phase of recovery from general anesthesia, characterized by anxiety, disorientation, violent, and irrational behavior. Many agents have been used as prophylaxis with varying degrees of succe...

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Main Authors: Ossama H. Salman, Hatem S. Ali Mohamed
Format: Article
Language:English
Published: SpringerOpen 2022-03-01
Series:Ain Shams Journal of Anesthesiology
Online Access:https://doi.org/10.1186/s42077-022-00219-0
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author Ossama H. Salman
Hatem S. Ali Mohamed
author_facet Ossama H. Salman
Hatem S. Ali Mohamed
author_sort Ossama H. Salman
collection DOAJ
description Abstract Background Emergence agitation is a potentially serious post-anesthetic event occurring in the early phase of recovery from general anesthesia, characterized by anxiety, disorientation, violent, and irrational behavior. Many agents have been used as prophylaxis with varying degrees of success. The purpose of this study was to compare the efficacy and safety of dexmedetomidine to magnesium sulfate in mitigating emergence agitation. Patients were randomly allocated to one of three groups of 35 each. Dexmedetomidine group (D group) received intraoperative Dex 0.7 μg/kg/h infusion (no loading dose). The magnesium sulfate group (M group) received intraoperative magnesium sulfate 20 mg/kg/h infusion (no loading dose). The control group (C group) received equal volume of saline infusion as placebo. Results The total incidence of emergence agitation was significantly lower in group D, 5.6% and group M, 8.5% compared to control group, 54.2%. The median time to extubation was significantly longer in group D than C and M groups (13, 7, and 8, respectively) and was not significantly different between group C and M. During recovery, the number of patients who experience pain was significantly lower in D and M groups compared to patients in control group (P < 0.002). The total dose of rescue analgesic was also significantly lower in D and M group versus control group (P < 0.001). Conclusions Dexmedetomidine and magnesium sulfate infusion are both equally effective in reducing the incidence of emergency agitation in obese adults undergoing nasal surgery. Extubation time and post-operative anesthesia care time were rather longer in dexmedetomidine than other groups. Trial registration Registered with ClinicalTrials.gov Identifier: NCT04531371
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spelling doaj.art-9c2299691a9c4ffa9fa356ad98f4482e2022-12-21T19:58:16ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2022-03-011411810.1186/s42077-022-00219-0Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgeryOssama H. Salman0Hatem S. Ali Mohamed1Department of Anesthesia, ICU and Pain Management, School of Medicine, South Valley UniversityDepartment of Anesthesia, ICU and Pain Management, School of Medicine, South Valley UniversityAbstract Background Emergence agitation is a potentially serious post-anesthetic event occurring in the early phase of recovery from general anesthesia, characterized by anxiety, disorientation, violent, and irrational behavior. Many agents have been used as prophylaxis with varying degrees of success. The purpose of this study was to compare the efficacy and safety of dexmedetomidine to magnesium sulfate in mitigating emergence agitation. Patients were randomly allocated to one of three groups of 35 each. Dexmedetomidine group (D group) received intraoperative Dex 0.7 μg/kg/h infusion (no loading dose). The magnesium sulfate group (M group) received intraoperative magnesium sulfate 20 mg/kg/h infusion (no loading dose). The control group (C group) received equal volume of saline infusion as placebo. Results The total incidence of emergence agitation was significantly lower in group D, 5.6% and group M, 8.5% compared to control group, 54.2%. The median time to extubation was significantly longer in group D than C and M groups (13, 7, and 8, respectively) and was not significantly different between group C and M. During recovery, the number of patients who experience pain was significantly lower in D and M groups compared to patients in control group (P < 0.002). The total dose of rescue analgesic was also significantly lower in D and M group versus control group (P < 0.001). Conclusions Dexmedetomidine and magnesium sulfate infusion are both equally effective in reducing the incidence of emergency agitation in obese adults undergoing nasal surgery. Extubation time and post-operative anesthesia care time were rather longer in dexmedetomidine than other groups. Trial registration Registered with ClinicalTrials.gov Identifier: NCT04531371https://doi.org/10.1186/s42077-022-00219-0
spellingShingle Ossama H. Salman
Hatem S. Ali Mohamed
Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
Ain Shams Journal of Anesthesiology
title Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
title_full Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
title_fullStr Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
title_full_unstemmed Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
title_short Comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
title_sort comparison between dexmedetomidine versus magnesium sulfate infusions for mitigating emergence agitation in obese adults undergoing nasal surgery
url https://doi.org/10.1186/s42077-022-00219-0
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