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Dexmedetomidine for Emergence Delirium and Agitation in Preschool Children Undergoing Adeno-Tonsillectomy: A Scoping

Simon Hanssen1, Sara Ali Abdul-Mahdi Hadi1, Felix Haidl1

  • 1Department of Anaesthesiology and Intensive Care, Akershus University Hospital, Lørenskog, Norway.

Acta Anaesthesiologica Scandinavica
|January 13, 2026
PubMed

Insights

This scoping review examines dexmedetomidine for preventing emergence delirium (ED) and agitation (EA) in preschool children after adenotonsillectomy. It maps current evidence and identifies gaps for this high-risk group.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology

Background:

  • Emergence delirium (ED) and emergence agitation (EA) are common postoperative behavioral disturbances in children.
  • Preschool-aged children (1-6 years) undergoing adenotonsillectomy are a high-risk group for ED/EA.
  • Dexmedetomidine, an α2-adrenergic agonist, shows promise for ED/EA prevention and management, but evidence in this specific pediatric subgroup is fragmented.

Purpose of the Study:

  • To conduct a scoping review mapping and characterizing the existing body of evidence on dexmedetomidine use for preventing or managing ED/EA.
  • To focus specifically on preschool children (1-6 years) undergoing adenotonsillectomy.
  • To identify evidence patterns, gaps, and inform future research and clinical practice.

Main Methods:

  • A comprehensive scoping review following JBI methodology and PRISMA-ScR guidelines.
  • Searches across multiple databases (MEDLINE, Embase, CINAHL, CENTRAL) and grey literature.
  • Independent screening and data extraction by two reviewers, focusing on dexmedetomidine administration, outcomes, and adverse events.

Main Results:

  • Data will be charted on dexmedetomidine dosing, routes, and timing.
  • The review will analyze effects on ED/EA, secondary outcomes, and adverse events.
  • A descriptive synthesis will highlight evidence patterns and gaps in the literature.

Conclusions:

  • This review will provide the first consolidated overview of dexmedetomidine use for ED/EA in preschool children undergoing adenotonsillectomy.
  • Findings aim to inform clinical practice regarding perioperative dexmedetomidine use.
  • The results will guide the design of future targeted clinical trials in this population.

Keywords:
adeno‐tonsillectomydexmedetomidineemergence agitationemergence deliriumpre‐school children

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