Effect of Dexmedetomidine on Emergence Characteristics in Patients Undergoing General Anaesthesia with Desflurane: An Observational Study

Background: Emergence agitation (EA) and delirium are recognized complications after desflurane anaesthesia, potentially compromising patient safety. Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has sedative, analgesic, and sympatholytic properties that may attenuate EA without causing significant respiratory depression. This study aimed to evaluate the effect of dexmedetomidine on emergence characteristics in adult patients undergoing general anaesthesia with desflurane. Material and Methods: This prospective, comparative observational study included 60 adult patients (ASA I–II, aged 18–60 years) scheduled for elective surgeries of less than 120 minutes duration under general anaesthesia. Patients were allocated into two groups (n = 30 each): Group D received dexmedetomidine (1 μg/kg IV infusion over 10 min), and Group C received saline placebo. Emergence and extubation times, incidence of EA (Riker Sedation-Agitation Scale ≥ 5), cough severity, pain scores (Cameron scale), and perioperative hemodynamic parameters were assessed. Results: Demographic variables and surgical duration were comparable between groups. Emergence and extubation times were similar (p > 0.05). EA occurred in significantly fewer patients in Group D (6.7%) compared with Group C (26.7%) (p = 0.006). Pain scores were lower in Group D (p = 0.037), while cough scores did not differ significantly. Hemodynamic stability was better maintained in Group D, with significantly lower HR, SBP, DBP, and MAP at extubation, 2 min post-extubation, and on PACU arrival (p < 0.05). No adverse events or complications were reported. Conclusion: Dexmedetomidine effectively reduced the incidence of emergence agitation and attenuated hemodynamic fluctuations without prolonging recovery or causing respiratory compromise in adult patients undergoing desflurane anaesthesia. Its perioperative use may enhance patient safety and improve recovery quality.

Keywords: Anaesthesia, General, Inhalation, Desflurane, Dexmedetomidine, Emergence Agitation, Hemodynamic.