Date of this Version

11-11-2025

Document Type

DNP Project

Rights

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Abstract

Background: Emergence delirium significantly affects pediatric patients in the postoperative period, leading to increased stress on the patient, caregiver, and post-anesthesia care unit (PACU) nurse. Dexamethasone has been one of the most effective drugs to date in preventing emergence delirium. Remimazolam is a new drug being tested for its use in preventing emergence delirium in pediatric patients. This project aimed to compare remimazolam and dexmedetomidine in their use for preventing emergence delirium in pediatric patients undergoing surgical procedures, present the findings in an educational module to anesthesia providers, and assess their acquired knowledge.

Methods: A literature review was conducted comparing dexmedetomidine and remimazolam for the prevention of emergence delirium in pediatric patients. The evidence collected showed that dexmedetomidine had more efficacy in preventing emergence delirium and decreasing postoperative pain, while remimazolam had variable effects. Both were effective at reducing preoperative anxiety and improving mask acceptance. An online educational module was then created using the results and presented to anesthesia providers, along with pre- and post-surveys, to assess the knowledge gained. The educational module was sent to alumni from a South Florida university using an anonymous online platform, a survey, and data collection. The results from the surveys were collected and analyzed to assess the participants' learning.

Results: A total of 23 anesthesia providers consented and began the survey and educational module, with 22 completing it in its entirety. The pre-test revealed that some providers had knowledge of dexmedetomidine, and only 47.8% stated they would use dexmedetomidine and remimazolam in their practice. Post-test results showed improvement on every question in the survey, with an increase to 77.3% of providers stating they would like to use both dexmedetomidine and remimazolam in their practice. There was a substantial positive shift in participants' knowledge of both drugs and their desire to use them.

Discussion: The educational module revealed learning and improvements in provider knowledge for both drugs on every question asked. After completing the QI project, providers were more likely to use both medications in their practice. The attrition rate is significantly low, which bodes well for the study. Although these results are positive, limitations such as the sample size and short duration of data collection limit the generalizability of the results. Despite these limitations, the project highlights the importance of ongoing learning throughout one's anesthesia career, as the field of medicine continues to evolve. Ongoing education and professional development help ensure that patients receive the safest and most competent care.

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