Effect of Dexmedetomidine on Stress Response and Emergence Agitation During Laparoscopic Surgery
Status:
Completed
Trial end date:
2016-12-01
Target enrollment:
Participant gender:
Summary
Emergence agitation is a post-anesthetic phenomenon that develops in the early phase of
general anesthesia recovery, and is characterized by agitation, confusion, disorientation,
and possible violent behavior. The incidence of emergence agitation is less common in adults
as compared to pediatric patients. It may lead to serious consequences for the patient such
as bleeding, falling, removal of catheters and self extubation, which lead to further
complications like hypoxia and aspiration.
Despite its common occurrence, unclear etiology, and serious sequelae, emergence agitation
has rarely been studied in adults.
The stress response to surgery is an unconscious response to tissue injury. Activation of the
sympathetic nervous system, increase of catabolic hormone release and pituitary gland
suppression are considered a response to surgical stress, in clinical practice these
activities cause changes in heart rate, blood pressure and biochemical fluctuations of
noradrenaline, adrenaline, dopamine, and cortisol. Above all, these fluctuations prolong
hospitalization and delay patients discharge.
Dexmedetomidine is a highly selective alpha-2 receptor agonist having sedative, analgesic and
sympatholytic properties. Decreased stress response to surgery ensuring a stable hemodynamic
state is a beneficial property of the agent. Peri-operative use of dexmedetomidine also
decreases postoperative opioid consumption, pain intensity, and antiemetic therapy. However,
the data related to the effects of dexmedetomidine on reducing agitation from general
anesthesia in adults are limited.