Retracted article-Dexmedetomidine Infusion for Prevention of Emergence Agitation after Nasal Surgery.

ABSTRACT

Emergence agitation, also known as emergence excitement, emergence delirium or post anaesthetic excitement is a well-recognized clinical phenomenon occurring in the immediate postoperative period following general anaesthesia.1 Though it is most often seen in children and elderly,2,3 with literature focused on this population, it can affect all age groups. Emergence is the transition from unconsciousness to full wakefulness4 and most often this transition from general anaesthesia is smooth and uneventful.5 Emergence agitation is usually seen during the first 15-30 minutes following awakening from general anaesthesia3,6 and has varied clinical presentation. It can be characterized by agitation, restlessness, hyperactivity, irritability, thrashing, crying, moaning, incoherence and uncooperative behaviour.3,4,6Though emergence agitation is well recognized clinically, it is not well understood. The reasons being, lack of clear definition, lack of reliable and valid assessment tools, difficulty in differentiating between agitation and pain and uncertainty about its clinical significance.2 The incidence reported in paediatric population is 12-13%3 and about 10-15% in geriatric age group.7,8 There are various risk factors recognized to be associated with EA. They are presence of an endotracheal tube or urinary catheter, pain, premedication with benzodiazepine, use of inhalational anaesthetics,3,5 breast, abdominal9 and otolaryngologic surgeries.10,11 Presence of hypoxia, hypothermia, hypoglycaemia, electrolyte disturbances and sepsis can in addition add on to the incidence of EA.3,5