206 - Precedex and Propofol on Emergence Delirium

Aim: Emergence delirium is a postoperative complication that may occur in patients who undergo sedation/general anesthesia. A literature review was conducted to demonstrate the difference, if any, of precedex and propofol on emergence delirium.

Methods: This paper reviews propofol and precedex on emergence delirium literature from 2019-2023. Literature search was conducted electronically using MEDLINE/PubMed database. MeSH terms included the following: “Propofol”, “precedex”,” emergence delirium” and “anesthesia”. Inclusion criteria: Clinical trials, human subjects, case report, articles written in English, randomized controlled trials, retrospective reviews and electronic chart reviews. Exclusion criteria: Non-human subjects, retrospective reviews not involving sedation or anesthesia, and research that primary focused on propofol and precedex.

Results: This literature review identified 9 papers that met inclusion criteria; 748 patients were in a double-blinded, randomized controlled study, aged 65 and older, with 732 patients in the final sample. One clinical study involving 150 children identified regimen with propofol bolus and precedex infusion had better findings on reducing post operative delirium as compared to the use of either agent alone.  One meta analysis literature demonstrated that the time in applying agent does make a difference in reducing the incidence of emergence delirium. Another study involving children undergoing cleft palate surgery suggests that precedex is superior to propofol in lowering ED.

Conclusion: This literature suggests that the use of precedex was found to be more effective in reducing emergence delirium compared to propofol. Despite its superiority, clinical practitioners must still consider the pros and cons prior to choosing a sedative agent.  


Identify Supporting Agency and Grant Number: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $7,828,403 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.