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

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 ( < 0.002). The total dose of rescue analgesic was also significantly lower in D and M group versus control group ( < 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 Identifier: NCT04531371