• Passaint F Hassan and Amany H Saleh.
• Unit of Pediatric Cardiothoracic Anesthesia, El Kasr Al Aini Hospital, Cairo University, Giza, Egypt - passaintf@yahoo.com.
• Minerva Anestesiol. 2024 Nov 12.

BackgroundEmergence agitation (EA) is non-purposeful agitation that occurs during the early stages of general anesthesia recovery. This randomized, double-blinded trial aimed to compare the effect of dexmedetomidine, ketamine, and magnesium sulfate on the severity of EA following sevoflurane-based anesthesia in pediatric cardiac catheterization. We examined the fixed doses and assessed the severity of agitation using the Pediatric Anesthesia Emergence Delirium Scale (PAED) score.MethodsOne hundred children undergoing heart catheterization without local anesthetic in the skin were randomly divided into four groups. The Dexmedetomidine (D) Group (N.=25) received dexmedetomidine 1 μg/kg IV over 10 min, then 0.5 μg/kg/h. The Magnesium Sulfate (M) Group (N.=25) received 15 mg/k MgSo4 IV over 10 min and then 10 mg/kg/h. The Ketamine (K) Group (N.=25) received 1 mg/kg ketamine over 10 min, then 1 mg/kg/h. The Control (C) Group (N.=25) received 0.9% saline at the same rate as other groups. All medications were diluted in 50 mL 0.9% saline.ResultsThe dexmedetomidine group exhibited a 0% incidence of EA, compared to 4% in the ketamine group, 12% in the MgSO4 group, and 40% in the control groups (P<0.001). Dexmedetomidine significantly reduced the PAED Scale and pain scores compared to the other groups. The effects of ketamine and MgSO4 on PAED and pain scores were comparable, with both treatments demonstrating significantly lower scores than the control group.ConclusionsDexmedetomidine exhibited higher efficacy than ketamine and magnesium sulfate in reducing the severity of postoperative EA. However, ketamine and magnesium sulfate demonstrated comparable efficacy, exceeding that of the control group.

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