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Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries

BACKGROUND: Emergence agitation (EA) in nasal surgeries is seen in around 22% of patients, which can go to dangerous levels. Dexmedetomidine is effective in prevention of EA in such patients. Midazolam given as premedication fails to prevent EA due to its short half-life. In this study, we compared...

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Autores principales: Kurhekar, Pranjali, Vinod, Krishnagopal, Rajarathinam, Buddhan, Dhiviya Krishna, J Shesha, Raghuraman, M. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789508/
https://www.ncbi.nlm.nih.gov/pubmed/29416458
http://dx.doi.org/10.4103/sja.SJA_419_17
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author Kurhekar, Pranjali
Vinod, Krishnagopal
Rajarathinam, Buddhan
Dhiviya Krishna, J Shesha
Raghuraman, M. S.
author_facet Kurhekar, Pranjali
Vinod, Krishnagopal
Rajarathinam, Buddhan
Dhiviya Krishna, J Shesha
Raghuraman, M. S.
author_sort Kurhekar, Pranjali
collection PubMed
description BACKGROUND: Emergence agitation (EA) in nasal surgeries is seen in around 22% of patients, which can go to dangerous levels. Dexmedetomidine is effective in prevention of EA in such patients. Midazolam given as premedication fails to prevent EA due to its short half-life. In this study, we compared efficacy of dexmedetomidine and midazolam by intravenous infusion for prevention of EA in adult nasal surgeries. MATERIALS AND METHODS: Seventy patients belonging to American society of anesthesiologist Status I and II, between 18 and 60 years of age posted for elective nasal surgeries were randomly divided into two groups. Group D received intravenous dexmedetomidine 0.5 mcg/kg over 15 min followed by 0.1 mcg/kg/h. Group M received intravenous midazolam 0.02 mg/kg over 15 min followed by 0.02 mg/kg/h. EA scores, emergence times, and hemodynamic parameters were monitored and compared between the groups. Statistical analysis was done by independent t-test, Mann–Whitney U-test, and Chi-square test as applicable. RESULTS: Incidence of EA was comparable between the groups (P = 0.23). Two patients in midazolam group developed dangerous agitation while none in dexmedetomidine group. Patients in midazolam group (12.4%) were agitated even in postoperative period, which was not seen with dexmedetomidine group. Hypotension and bradycardia were seen more in dexmedetomidine group. CONCLUSION: Efficacy of midazolam when given as an intravenous infusion is comparable to dexmedetomidine in prevention of EA in nasal surgeries.
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spelling pubmed-57895082018-02-07 Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries Kurhekar, Pranjali Vinod, Krishnagopal Rajarathinam, Buddhan Dhiviya Krishna, J Shesha Raghuraman, M. S. Saudi J Anaesth Original Article BACKGROUND: Emergence agitation (EA) in nasal surgeries is seen in around 22% of patients, which can go to dangerous levels. Dexmedetomidine is effective in prevention of EA in such patients. Midazolam given as premedication fails to prevent EA due to its short half-life. In this study, we compared efficacy of dexmedetomidine and midazolam by intravenous infusion for prevention of EA in adult nasal surgeries. MATERIALS AND METHODS: Seventy patients belonging to American society of anesthesiologist Status I and II, between 18 and 60 years of age posted for elective nasal surgeries were randomly divided into two groups. Group D received intravenous dexmedetomidine 0.5 mcg/kg over 15 min followed by 0.1 mcg/kg/h. Group M received intravenous midazolam 0.02 mg/kg over 15 min followed by 0.02 mg/kg/h. EA scores, emergence times, and hemodynamic parameters were monitored and compared between the groups. Statistical analysis was done by independent t-test, Mann–Whitney U-test, and Chi-square test as applicable. RESULTS: Incidence of EA was comparable between the groups (P = 0.23). Two patients in midazolam group developed dangerous agitation while none in dexmedetomidine group. Patients in midazolam group (12.4%) were agitated even in postoperative period, which was not seen with dexmedetomidine group. Hypotension and bradycardia were seen more in dexmedetomidine group. CONCLUSION: Efficacy of midazolam when given as an intravenous infusion is comparable to dexmedetomidine in prevention of EA in nasal surgeries. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5789508/ /pubmed/29416458 http://dx.doi.org/10.4103/sja.SJA_419_17 Text en Copyright: © 2018 Saudi Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3%.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kurhekar, Pranjali
Vinod, Krishnagopal
Rajarathinam, Buddhan
Dhiviya Krishna, J Shesha
Raghuraman, M. S.
Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title_full Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title_fullStr Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title_full_unstemmed Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title_short Randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
title_sort randomized comparison between dexmedetomidine and midazolam for prevention of emergence agitation after nasal surgeries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789508/
https://www.ncbi.nlm.nih.gov/pubmed/29416458
http://dx.doi.org/10.4103/sja.SJA_419_17
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