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

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.