• Tamer Samir Abdelsalam Abdelaziz, Hatem Elsayed Mohammed Elsayed, Doaa Mohammed Kamal Eldin, and Ismail Mohammed Ibrahim.
• Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt. drtasamir@hotmail.com.
• BMC Anesthesiol. 2025 Jan 31; 25 (1): 5050.

BackgroundEmergence agitation EA is a state of confusion and harmful aggressiveness during recovery. It is a common complication after rhinoplasty, with risk of trauma, bleeding, and hemodynamic instability. Dexmedetomidine and gabapentin premedication could improve the quality of recovery after rhinoplasty.MethodsOne hundred fifty-three participants (ASA I-II, both sexes and age 18-40 years) scheduled for rhinoplasty were randomized into three groups. Group C didn't receive premedication, Group D received intramuscular (IM) dexmedetomidine, and Group G received oral gabapentin. The degree of EA by Riker sedation-agitation scale (RSAS) during recovery, pain severity, and adverse events recorded.ResultsThe results showed statistically significant differences in EA scores with the lowest values in group D (p-value 0.002). Moreover, the incidence of EA was 17.6% (9/51) in Group D, 41.2% (21/51) in Group G, and 56.9% (29/51) in Group C with P value < 0.001 and significant differences in VAS score at 4, 8, and 12 h with the highest median (range) values in group C 4(3-6) in comparison to group D 2(1-3) and group G 2(1-3) and p-value < 0.001; no significant differences in adverse events.ConclusionsIM dexmedetomidine premedication was more efficient than gabapentin in the reduction of the emergence agitation incidence, severity, and postoperative pain scores after rhinoplasty in adults.Clinical Trial Registration Number IdNCT05626998 on 25/11/2022.© 2025. The Author(s).

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