• Anaesthesia · Oct 2013

    Randomized Controlled Trial

    The effect of magnesium sulphate infusion on the incidence and severity of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia.

    • M Abdulatif, A Ahmed, A Mukhtar, and S Badawy.
    • Anaesthetic Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
    • Anaesthesia. 2013 Oct 1;68(10):1045-52.

    AbstractThis randomised, controlled, double-blind study investigated the effects of intra-operative magnesium sulphate administration on the incidence of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia. Seventy children were randomly allocated to receive a 30 mg.kg(-1) bolus of intravenous magnesium sulphate after induction of anaesthesia followed by a continuous infusion of 10 mg.kg(-1).h(-1) or an equal volume of saline 0.9%. All children received titrated sevoflurane anaesthesia adjusted to maintain haemodynamic stability. The Pediatric Anesthesia Emergence Delirium scale and the Children's Hospital of Eastern Ontario Score were used for the assessment of postoperative emergence agitation and pain, respectively. Emergence agitation was more common in the control group than in the magnesium group (23 (72%) and 12 (36%), respectively (p = 0.004)), with a relative risk of 0.51 (95% CI 0.31-0.84), an absolute risk reduction of 0.35 (95% CI 0.10-0.54), and number needed to treat of 3 (95% CI 2-9). Postoperative pain scores were comparable in the two groups. Magnesium sulphate reduces the incidence and severity of emergence agitation in children undergoing adenotonsillectomy using sevoflurane anaesthesia and is not associated with increased postoperative side-effects or delayed recovery.© 2013 The Association of Anaesthetists of Great Britain and Ireland.

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    This article appears in the collection: The wonderful world of perioperative magnesium.

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    1mcg/kg fentanyl as sole intraoperative analgesic is less than most instutions would administer and may explain a high baseline postoperative agitation rate.

    Pieter Peach  Pieter Peach
     
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