Abdelaziz Tamer Samir Abdelsalam, Mohammed Elsayed Hatem Elsayed, Kamal Eldin Doaa Mohammed, Ibrahim Ismail Mohammed
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
BMC Anesthesiol. 2025 Jan 31;25(1):50. doi: 10.1186/s12871-025-02914-5.
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.
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.
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.
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.
NCT05626998 on 25/11/2022.
苏醒期躁动（EA）是恢复过程中出现的一种意识混乱和有害攻击性行为的状态。它是隆鼻术后常见的并发症，存在创伤、出血和血流动力学不稳定的风险。右美托咪定和加巴喷丁预处理可改善隆鼻术后的恢复质量。
153例计划行隆鼻术的参与者（美国麻醉医师协会身体状况分级I-II级，男女不限，年龄18-40岁）被随机分为三组。C组未接受预处理，D组接受肌肉注射（IM）右美托咪定，G组接受口服加巴喷丁。记录恢复期间使用Riker镇静-躁动量表（RSAS）评估的EA程度、疼痛严重程度和不良事件。
结果显示，EA评分存在统计学显著差异，D组最低（p值0.002）。此外，D组EA发生率为17.6%（9/51），G组为41.2%（21/51），C组为56.9%（29/51），P值<0.001；在4、8和12小时时视觉模拟评分（VAS）存在显著差异，C组中位数（范围）最高，为4(3-6)，而D组为2(1-3)，G组为2(1-3)，p值<0.001；不良事件无显著差异。
在降低成人隆鼻术后苏醒期躁动发生率、严重程度和术后疼痛评分方面，肌肉注射右美托咪定预处理比加巴喷丁更有效。
2022年11月25日的NCT05626998。
