Dexmedetomidine reduces emergence agitation and catheter-related bladder discomfort after abdominal surgery: a single center, prospective, double blind randomized controlled trial

We explored whether dexmedetomidine administration during anaesthesia recovery could improve postoperative short-term Catheter-Related Bladder Discomfort (CRBD), emergence agitation (EA), and pain. A total of 269 patients who underwent abdominal surgery were included in the analysis. Patients were randomly assigned to either the dexmedetomidine group (group D, n = 136), which received 0.2 µg/kg dexmedetomidine after being transferred to the Postanesthesia Care Unit (PACU), or the control group (group C, n = 133). The outcome measures included EA, CRBD, pain, blood pressure, and heart rate in the PACU; demand for additional analgesic medication; length of PACU stay and protective restraints; and postoperative nausea and vomiting (PONV). No differences were observed in the baseline data. Patients in group D had lower incidence of EA (1.5% vs. 30.8% at extubation, p < 0.001; 0.0% vs. 9.0% 10 min after extubation, p < 0.001). Group D patients had lower pain scores at all observation time points in the PACU (all p < 0.001) and lower CRBD ratings (all p < 0.001), and no patients in group D had CRBD ≥ 3. Group D patients had a longer PACU stay (50.00 (30.00) vs. 45.00 (25.00) min, p = 0.042). There were no statistical differences in analgesic drug requirements or incidence of PONV, and no significant differences were observed in blood pressure and heart rate. Administration of low-dose dexmedetomidine in the PACU reduced the incidence of EA and CRBD and short-term postoperative pain scores. Trial registration The trial was registered before patient enrolment in the Chinese Clinical Trial Registry (registry no. ChiCTR2500107721, registration date: August 18, 2025).