Background: Emergence agitation (EA) is a common and potentially hazardous complication during recovery from general anaesthesia, particularly following nasal surgeries due to postoperative nasal packing and airway discomfort. Dexmedetomidine, a selective α₂-adrenergic agonist, possesses sedative, anxiolytic, and analgesic properties without causing respiratory depression and may reduce the incidence of EA. Aim: To evaluate the effect of intraoperative dexmedetomidine infusion on the prevention of emergence agitation in adult patients undergoing nasal surgery under general anaesthesia. Methods: This randomized, double-blinded, placebo-controlled study included 100 adult patients (ASA physical status I–II) scheduled for elective nasal surgery with postoperative nasal packing. Patients were allocated into two groups: Group D received dexmedetomidine infusion at 0.4 μg/kg/hour from induction until extubation, while Group C received a volume-matched saline infusion. Emergence agitation was assessed using the Riker Sedation–Agitation Scale during the emergence period. Secondary outcomes included hemodynamic parameters, time to extubation, time to verbal response, intraoperative opioid requirement, postoperative complications, and PACU stay. Results: The incidence of emergence agitation was significantly lower in the dexmedetomidine group compared to the control group (4% vs. 58%, p < 0.001). Patients receiving dexmedetomidine demonstrated better hemodynamic stability and reduced intraoperative fentanyl requirements. Although time to verbal response and extubation were slightly prolonged in the dexmedetomidine group, these differences were not clinically significant and did not prolong PACU stay. No severe emergence agitation or major adverse effects were observed in either group. Conclusion: Intraoperative dexmedetomidine infusion significantly reduces the incidence of emergence agitation in adults undergoing nasal surgery. It provides smoother emergence, improved hemodynamic stability, and an opioid-sparing effect without delaying recovery, making it a safe and effective strategy for preventing emergence agitation in this high-risk population.

Emergence agitation, Dexmedetomidine, Nasal surgery, General anaesthesia, Smooth emergence.