The Efficacy of Oral Dexmedetomidine as an Anesthetic Pre-operative Medication and as a Deterrent to Emergence Delirium

Introduction: Emergence delirium (ED) has been described as “…a mental disturbance during the recovery from general anesthesia consisting of hallucinations, delusions and confusion manifested by moaning, restlessness, involuntary physical activity, and thrashing about in bed”(Sikich & Lerman, 2004). This phenomenon has been considered a common post-anesthetic problem in children and adults since its description in the literature in 1960. According to Cole, Muray, McAllister & Hirshberg (2002), ED occurs most frequently in the initial ten minutes of recovery, but many children who arrive in a post-anesthesia recovery area asleep experience agitation later during recovery. There are multiple definitions of ED in the literature, with associated prevalence in children ranging from 25-80%, and typically occurring within the first 30 minutes following emergence from anesthesia (Sikich & Lerman, 2004). The most plausible reason for the range in reported prevalence of ED in children is likely attributable to the diversity in definition. Likewise, the reported severity of emergence delirium in the pediatric anesthesia population has varied widely between observers, with the one constant being an almost universally unpredictable presentation.