Efficacy Dexmedetomidine and Propofol in prevention of Emergence Delirium after using sevoflurane in pediatric patients

Emergence Delirium(ED) is considered a major problem during early stages of recovery from general anaesthesia in children . It’s characterised by psychomotor agitation , perceptual disturbances , hallucinations , agitation , confusion. This also includes inconsolable crying , moaning , restlessness , thrashing on bed.Various etiologically factors have been known to cause it like Pre school age , Pre operative anxiety, surgical procedures like otorhinology , ophthalmology procedures etc and also mode of Anaesthesia (inhalational , intravenous) and Postoperative pain. Sevoflurane ia a preferred inhalational agent for pediatric population due to lack of airway irritation , hemodynamic stability , sweet smell, low cardio depressive effect , hepatotoxicity , and rapid recovery from anaesthesia. Emergence Delirium in pediatric patients who underwent surgeries under general anaesthesia using sevoflurane.When pain and other cofounders are controlled, the incidence is around 20-30% , Multiple drugs have been used in previous studies to prevent ED including fentanyl , propofol , Benzodiazapines etcDexmedetomidine due to its alpha agonist activity provides better sedation, analgesia and antiemetic effect with no respiratory depression at clinical dosages . It is potent analgesic , provides anxiolysis and sedation. To be given 0.2 MCG/kg diluted upto 20 ml with NS over 10 minutes.Propofol is non opioid , non barbiturate , sedative , hypnotic agent with rapid onset and short duration of action.It showed an overall protective effect against ED , when given as a bolus at the end of anaesthesia. Dose to be given is 0.1 mg/kg.In this study we hypothesise that dexmedetomidine and propofol both are equally effective in preventing ED caused due to sevoflurane.The aim of this study is to determine whether dexmedetomidine or propofol administered just before termination of sevoflurane decrease the incidence of ED caused due to sevoflurane