The effect of intravenous paracetamol on emergence agitation in preschool-aged children under sevoflurane anesthesia for strabismus surgery

Yeliz Kılıç, Haluk Hüseyin Gürsoy, Sema Şanal Baş, Ayten Bilir, Mehmet Sacit Güleç
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Abstract

Background: Emergence agitation (EA), a clinical phenomenon characterized by negative behaviors, is commonly observed in preschool-aged population. Paracetamol is a frequently preferred analgesic for postoperative pain in pediatrics due to low adverse effect profile. However, the preventive or therapeutic effectiveness of intravenous (IV) paracetamol on EA has not been fully elucidated, particularly in preschool-aged children. This study aimed to demonstrate the efficacy of IV paracetamol on EA in children who underwent strabismus surgery. Methods: Twenty seven patients were divided into two groups; preschool-aged children between 2 and 6 years old (Group 1) and children > 6 years old (Group 2). After anesthesia induction and before the surgical incision, IV paracetamol (10 mg/kg) was given to all cases. Face, Legs, Activity, Cry, and Consolability (FLACC) scale was used to assess the postoperative pain level while EA was evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scale. The two groups were then compared each other in terms of FLACC and PAED scores. Results: THere were 15 and 12 patients in Group 1 and Group 2, respectively. No significant differences in FLACC and PAED scores were found similar between the two groups (p>0.05). The number of patients with ED was similar between the groups (p>0.05). Conclusions: IV paracetamol was found effective in the management of postoperative pain and EA in preschool-aged children who underwent strabismus surgery with sevoflurane anesthesia.
静脉注射扑热息痛对学龄前儿童斜视手术七氟醚麻醉下突发性躁动的影响
背景:涌现性躁动是学龄前儿童普遍存在的一种以消极行为为特征的临床现象。对乙酰氨基酚因其不良反应低而成为儿科术后疼痛的常用镇痛药。然而,静脉注射(IV)扑热息痛对EA的预防或治疗效果尚未完全阐明,特别是在学龄前儿童中。本研究旨在证明静脉注射扑热息痛对斜视手术儿童EA的疗效。方法:27例患者分为两组;2 ~ 6岁学龄前儿童(第1组)和> 6岁儿童(第2组)。麻醉诱导后及手术切口前给予静脉扑热息痛(10 mg/kg)。采用面部、腿部、活动、哭泣和安慰(FLACC)量表评估术后疼痛水平,采用儿科麻醉紧急谵妄(PAED)量表评估EA。然后比较两组的FLACC和PAED评分。结果:1组15例,2组12例。两组患者FLACC、PAED评分差异无统计学意义(p>0.05)。两组患者发生ED的人数比较,差异无统计学意义(p>0.05)。结论:静脉注射扑热息痛对七氟醚麻醉下学龄前儿童斜视手术术后疼痛和EA有较好的治疗效果。
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