“The effect of intramuscular dexmedetomidine versus oral gabapentin premedication on the emergence agitation after rhinoplasty”. A prospective, randomized, double-blind controlled trial

Abstract Background Emergence agitation EA is a state of confusion and harmful aggressiveness during recovery. It is a common complication after rhinoplasty, with risk of trauma, bleeding, and hemodynamic instability. Dexmedetomidine and gabapentin premedication could improve the quality of recovery...

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Main Authors: Tamer Samir Abdelsalam Abdelaziz, Hatem Elsayed Mohammed Elsayed, Doaa Mohammed Kamal Eldin, Ismail Mohammed Ibrahim
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-02914-5
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Summary:Abstract Background Emergence agitation EA is a state of confusion and harmful aggressiveness during recovery. It is a common complication after rhinoplasty, with risk of trauma, bleeding, and hemodynamic instability. Dexmedetomidine and gabapentin premedication could improve the quality of recovery after rhinoplasty. Methods One hundred fifty-three participants (ASA I-II, both sexes and age 18–40 years) scheduled for rhinoplasty were randomized into three groups. Group C didn’t receive premedication, Group D received intramuscular (IM) dexmedetomidine, and Group G received oral gabapentin. The degree of EA by Riker sedation-agitation scale (RSAS) during recovery, pain severity, and adverse events recorded. Results The results showed statistically significant differences in EA scores with the lowest values in group D (p-value 0.002). Moreover, the incidence of EA was 17.6% (9/51) in Group D, 41.2% (21/51) in Group G, and 56.9% (29/51) in Group C with P value < 0.001 and significant differences in VAS score at 4, 8, and 12 h with the highest median (range) values in group C 4(3–6) in comparison to group D 2(1–3) and group G 2(1–3) and p-value < 0.001; no significant differences in adverse events. Conclusions IM dexmedetomidine premedication was more efficient than gabapentin in the reduction of the emergence agitation incidence, severity, and postoperative pain scores after rhinoplasty in adults. Clinical trial registration number ID NCT05626998 on 25/11/2022.
ISSN:1471-2253