A Randomized, Double-Blind Study Comparing Dexmedetomidine and Fentanyl in Preventing Emergence Agitation in Adult Patients After Laparoscopic Surgeries Under Sevoflurane Anesthesia(T0015)

Introduction: Emergence agitation (EA) is a temporary and self-limiting condition characterized by restlessness, confusion, and agitation during the early recovery phase following anesthesia. The incidence of EA is notably higher with the use of inhalational anesthetics such as Sevoflurane.

Aims and Objectives:

Primary Objective:
To evaluate the effectiveness of Inj. Dexmedetomidine and Inj. Fentanyl in preventing emergence agitation in patients undergoing laparoscopic surgeries following Sevoflurane anesthesia.

Secondary Objectives:

1. To assess the incidence of emergence agitation for 24 hours postoperatively in patients who received Sevoflurane during laparoscopic surgeries.
2. To compare hemodynamic stability in patients receiving either Inj. Dexmedetomidine or Inj. Fentanyl during laparoscopic surgeries under general anesthesia with Sevoflurane.
3. To monitor potential complications such as bradycardia, hypotension, and respiratory depression with the use of Inj. Dexmedetomidine or Inj. Fentanyl in laparoscopic surgeries.

Methods:
This randomized, double-blinded prospective study involved 72 adult patients aged 18–60 years, classified as ASA grade I–II, undergoing elective laparoscopic surgeries. Patients were randomly assigned to two groups: Group D (receiving Dexmedetomidine 1 mcg/kg IV) and Group F (receiving Fentanyl 1 mcg/kg IV). Intraoperative and postoperative monitoring included hemodynamic parameters, incidence of EA, and complications like bradycardia and hypotension, observed for 24 hours postoperatively. EA was measured using the Riker Sedation-Agitation Scale.

Results:
Dexmedetomidine was significantly more effective than Fentanyl in reducing the incidence of EA (p < 0.05). Hemodynamic stability was better in the Dexmedetomidine group, with fewer occurrences of tachycardia and hypertension. Both groups showed minimal complications, with no severe adverse effects reported.

Conclusion:
Dexmedetomidine is more effective than Fentanyl in preventing emergence agitation in adult patients undergoing laparoscopic surgeries under Sevoflurane anesthesia. It also provides superior hemodynamic stability, with both drugs showing comparable safety profiles.

Keywords: Emergence Agitation, Dexmedetomidine, Fentanyl, Sevoflurane, Laparoscopic Surgery, Hemodynamic Stability.