Dexmedetomidine for Emergence Delirium and Agitation in Preschool Children Undergoing Adeno‐Tonsillectomy: A Scoping Review Protocol

ABSTRACT Emergence delirium (ED) and emergence agitation (EA) are behavioural disturbances in the early postoperative period in children. Preschool‐aged children (1–6 years) undergoing adeno‐tonsillectomy constitute a high‐risk group. The α 2 ‐adrenergic agonist dexmedetomidine has emerged as a potential preventive/therapeutic agent for ED/EA, but evidence in this specific subgroup is fragmented. To map and characterise the body of evidence regarding dexmedetomidine use for preventing or managing ED/EA in preschool children undergoing adeno‐tonsillectomy. A scoping review will be conducted in accordance with JBI methodology and reported via the PRISMA‐ScR checklist. Searches will be performed in MEDLINE, Embase, CINAHL, CENTRAL, and grey literature. Eligible studies will include preschool (1–6 years) children undergoing adeno‐tonsillectomy where dexmedetomidine was used perioperatively. Two reviewers will screen and extract data independently. Data will be charted on dexmedetomidine dosing, routes, timing, outcome definitions, effects on ED/EA, secondary outcomes, and adverse events. A descriptive synthesis will identify evidence patterns and gaps. This review will provide the first consolidated overview of dexmedetomidine use specifically in preschool children undergoing adeno‐tonsillectomy for ED/EA prevention or management. The findings may inform clinical practice and guide future targeted trials.