Abstract
This study investigated whether intraoperative infusion of magnesium sulphate reduces the incidence of emergence agitation (EA) in paediatric patients who undergo ambulatory ophthalmic surgery using the Paediatric Anaesthesia Emergence Delirium (PAED) scale. Ninety-two paediatric patients who were scheduled for elective ophthalmic surgery were randomly allocated to two groups: control or magnesium. In the magnesium group, patients received an initial intravenous loading dose of 30 mg/kg of 10% solution of magnesium sulphate over 10 min and then a continuous infusion of 10 mg/kg×h during the surgery. In the control group, an equal volume of 0.9% isotonic saline was administered in the same way as in the magnesium group. The PAED scale was assessed at 15-min intervals until the PAED score reached below 10 at the postanaesthetic care unit. EA was defined as a PAED score of 10 or higher. Of the 86 patients recruited, 44 and 42 were allocated to the control and magnesium groups, respectively. The incidence of EA was 77.3% in the control group and 57.1% in the magnesium group (odds ratio, 0.392; 95% confidence interval, 0.154 to 0.997; p = 0.046). The intraoperative infusion of magnesium sulphate significantly reduced the incidence of EA.
Highlights
Emergence agitation (EA) is one of the most common postoperative complications during recovery from general anaesthesia
The reported incidence of EA varies widely, ranging from 30% to 80% depending on definition, research background, assessment method and monitoring period used in each study [1,2,3]
While EA can occur in any age group, it is more commonly observed in children aged 3–9 years [2]
Summary
Emergence agitation (EA) is one of the most common postoperative complications during recovery from general anaesthesia. The reported incidence of EA varies widely, ranging from 30% to 80% depending on definition, research background (patients’ age group, surgical site or type of surgery, etc.), assessment method and monitoring period used in each study [1,2,3]. It has further been reported that the administration of sevoflurane and desflurane as general anaesthetics increases the onset of EA [4,5]. Ophthalmic and otorhinolaryngological surgeries are considered risk factors for EA [6]. Pain is known to be one of the risk factors of EA, it remains controversial whether pain is closely associated with the occurrence of EA [7,8,9,10]. The incidence of EA is reportedly 38% when sevoflurane is administered for minor procedures without any additional medication for pain [5]
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