Comparing two doses of dexmedetomidine infusion on emergence agitation using desflurane in paediatric surgeries under general anesthesia

Emergence agitation (EA) has been defined as a dissociated state of consciousness in which the child is inconsolable, irritable, uncooperative, typically thrashing, crying and  moaning . EA may cause physical harms to patient such as bleeding from site of surgery, psychological trauma, and delayed discharge from postanaesthetic care unit .Children display a variety of behaviour during anaesthetic recovery. Emergence agitation in children is a common problem with sevoflurane anaesthesia which include phenomenon such as crying, excitation, agitation, delirium and behavioural disturbances during early emergence from general anaesthesia . This phenomenon must be prevented by providing smooth emergence to paediatric patients.Postoperative emergence agitation is a common complication in paediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression.

Dexmedetomidine is highly specific α2 agonist and  has an analgesic-sparing effect and reduces emergence agitation Dexmedetomidine, , has been shown to prevent emergence delirium and agitation. Administered intravenously, dexmedetomidine is indicated for the sedation of initially intubated and mechanically ventilated patients during treatment in intensive care settings, and for the sedation of non-intubated patients prior to or during surgery and other procedures.

Recently, dexmedetomidine is known to decrease EA in paediatric and day-care surgery following sevoflurane. However, dexmedetomidine IV after anesthetic induction significantly decreases the occurrence of emergence agitation in children undergoing sevoflurane anesthesia.  but its role in preventing post desflurane Emergence Agitation EA has not been elucidated in some studies .