DOI

10.21007/con.dnp.2026.0134

Faculty Advisor

Dwanye Accardo, DNP, CRNA, FAANA

Document Type

Poster

Publication Date

2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Nursing Administration | Pediatric Nursing | Quality Improvement

Abstract

Purpose/Background 

Propofol is widely regarded as the standard anesthetic agent for preventing and treating emergence delirium, particularly in pediatric patients. Emergence delirium presents as postoperative agitation that may escalate to self-injurious behavior that can lead to disruption of critical lines or equipment. Since its approval in 1999, dexmedetomidine has gained attention for its sedative and sympatholytic properties, offering potential advantages over propofol. This study compares the postoperative effects of propofol and dexmedetomidine in reducing emergence delirium in pediatric surgical patients.

Methods 

A scoping review was conducted using PRISMA guidelines to identify relevant literature published between 2000 and 2025. Databases searched included PubMed, CINAHL, Embase, MEDLINE, Cochrane Library, Google Scholar, and ClinicalTrials.gov. Inclusion criteria consisted of peer-reviewed studies involving pediatric patients ages 2-18 years undergoing general anesthesia with direct comparison of dexmedetomidine and propofol. Ten high-quality studies, including randomized controlled trials and systematic reviews/meta-analyses, were selected for synthesis.

Results 

Of the study sample (n=10), all studies consistently demonstrated greater reductions in the incidence and severity of pediatric emergence delirium with dexmedetomidine than with propofol. All studies evaluating emergence delirium reported improved outcomes with dexmedetomidine use, although they noted a longer time to awakening that did not negatively 3

impact overall recovery or length of stay. Overall, this scoping review's findings support the use of dexmedetomidine as a more effective agent than propofol for reducing emergence delirium in pediatric patients undergoing general anesthesia.

Implications for Nursing Practice 

The results of this scoping review imply that dexmedetomidine is the superior agent in reducing pediatric emergence delirium in patients undergoing general anesthesia. Practitioners should be aware that dexmedetomidine will likely increase the time to awakening, but the benefit of decreased postoperative agitation outweighs the risk of a longer wake up time.

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