Effect of a subanesthetic dose of propofol on emergence agitation in adults undergoing rhinoplasty: A prospective randomized controlled trial
Medicine, cilt.105, sa.28, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 105 Sayı: 28
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/md.0000000000049693
- Dergi Adı: Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
- Anahtar Kelimeler: emergence agitation, postoperative complications, propofol, recovery, rhinoplasty
- Van Yüzüncü Yıl Üniversitesi Adresli: Evet
Özet
BACKGROUND: Emergence agitation (EA) following rhinoplasty can jeopardize surgical outcomes through increased bleeding and hematoma formation. Data on the efficacy of subanesthetic propofol for EA prevention in adults remain limited compared to pediatric populations. This study evaluated the effects of a single subanesthetic dose of propofol administered prior to extubation on the incidence of EA, recovery profile, and patient satisfaction in adult rhinoplasty patients. METHODS: In this prospective, randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov: https://clinicaltrials.gov/show/NCT07276633), 80 adult patients (American Society of Anesthesiologists I-II) undergoing elective rhinoplasty were randomly allocated (1:1) to receive either intravenous propofol 0.5 mg/kg (Group P, n = 40) or 0.9% saline (Group S, n = 40) 10 minutes before the anticipated end of surgery. The primary endpoint was the incidence of EA (defined as a maximum Richmond Agitation-Sedation Scale score ≥ +1). Secondary endpoints included recovery time, patient satisfaction (3-point Likert scale), and adverse events. RESULTS: The incidence of EA was significantly lower in Group P compared to Group S (60.0% vs 92.5%; relative risk = 0.65, 95% confidence interval: 0.50-0.85; P < .001). Although the mean recovery time was significantly prolonged in Group P (10.0 ± 1.1 minute vs 5.5 ± 1.5 minutes; mean difference = 4.5 minutes, 95% confidence interval: 3.92-5.08; P < .001), patient satisfaction scores were markedly higher (P < .001). No statistically significant differences were observed in the incidence of adverse events, including laryngospasm (0% vs 7.5%, P = .241) or postoperative nausea and vomiting (5.0% vs 2.5%, P = .550). CONCLUSION: Administration of a subanesthetic dose of propofol (0.5 mg/kg) before extubation was associated with a reduced incidence of EA and improved early postoperative satisfaction in adults undergoing rhinoplasty. While this intervention modestly prolonged recovery time, the delay appeared clinically manageable, suggesting that targeted propofol administration may be a valuable adjunct for optimizing emergence quality in this high-risk population.