Comparison on the Effectiveness of Intravenous Magnesium Sulphate and Intravenous Dexmedetomidine in Reducing Emergence Agitation in Adults Undergoing Otorhinolaryngology Surgery.

BACKGROUND

Emergence agitation (EA) is a phenomenon commonly occurring in otorhinolaryngology surgery. It may increase the risk of injury and prolong recovery. Dexmedetomidine is the standard preventive agent, but limited due to its high cost, limited accessibility, extubation time, and incidence of bradycardia and hypotension. Magnesium sulphate (MgSO4) is considered a potential alternative but is there is insufficient research available. This study aimed to compare the effectiveness of intravenous MgSO4 and dexmedetomidine in reducing EA.

METHODS

This study is a multicentered, double-blinded, randomized controlled trial involving 64 adult patients undergoing otorhinolaryngology surgery. They were divided into two groups in a 1:1 ratio, with one group receiving MgSO4 20 mg/kgBW/h and another receiving dexmedetomidine 0.5 μg/kgBW/h from induction until the procedure ends. We measured the proportion of EA, onset, and duration of EA, intraoperative ephedrine dose, perioperative heart rate and mean arterial pressure (MAP), pain scores, perioperative fentanyl use, intraoperative sevoflurane use, and extubation time.

RESULTS

The proportion of EA was not significantly different between the MgSO4 and dexmedetomidine groups (12.5% vs. 15.6%, p > 0.05). No differences in the severity, onset and duration of EA. The reduction of MAP and heart rate were greater in the dexmedetomidine group. The intraoperative ephedrine was significantly lower in the MgSO4 group (0 vs. 5 mg, p < 0.05). No significant differences in fentanyl and sevoflurane use, postoperative pain scores, and extubation time.

CONCLUSION

Intravenous MgSO4 and dexmedetomidine showed no statistically significant difference in the incidence of EA in adult patients undergoing otorhinolaryngologic surgery. Trial Registration: ClinicalTrials.gov: NCT07544173.