Efficacy of intraoperative dexmedetomidine infusion for mitigating emergence agitation in elderly patients undergoing abdominal cancer surgery. A prospective, randomized, double-blind, controlled trial

Background: Emerging agitation occurs frequently in clinical anesthesia, especially elderly patient. Prevention of developing agitation enhanced clinical outcomes. Dexmedetomidine can reduce adult agitation and its early symptoms.Objective: This study evaluated the effectiveness of intraoperative dexmedetomidine infusion versus normal saline in mitigating the incidence and intensity of postoperative agitation.Methods: This study included eighty adult male and female patients aged over 60 who received elective abdominal cancer surgery and were assigned with a physical status ranging from I to III according to the American Society of Anesthesiologists (ASA). The two groups with forty patients each were randomly assigned: Group C got regular saline infusion, while Group D got a continuous infusion of dexmedetomidine. Postoperative agitation was assessed via the Richmond Agitation Sedation Scale (RASS).Results: Assessment of emergence agitation using the RASS demonstrated that the Dexmedetomidine Group experienced significantly lower levels of agitation in the immediate postoperative period compared to the Control Group. While RASS scores were comparable at 2 minutes (P = 0.055), the Dexmedetomidine Group achieved a consistently calmer emergence starting at 4 minutes post-extubation (mean RASS -1.5 ± 1.4 vs. 0.0 ± 1.4, P < 0.001) and maintained significantly lower RASS scores through the 10-minute assessment (P = 0.032), with no significant disparities observed in demographic data or mean blood pressure.Conclusion: In elderly patients receiving elective abdominal cancer surgery, the incidence and intensity of postoperative agitation were considerably decreased by intraoperative dexmedetomidine infusion. This suggests that dexmedetomidine effectively mitigates emergence agitation in this high-risk population.