698 results match your criteria emergence delirium

Perioperative dexmedetomidine reduces emergence agitation without increasing the oculocardiac reflex in children: A systematic review and meta-analysis.

Medicine (Baltimore) 2021 May;100(18):e25717

Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, China.

Background: Intravenous dexmedetomidine (DEX) has been used to prevent emergence agitation (EA) in children. The aim of this meta-analysis was to evaluate whether DEX decreases EA incidence without augmenting oculocardiac reflex (OCR) in pediatric patients undergoing strabismus surgery.

Methods: We searched PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library to collect the randomized controlled trials (RCTs) investigating the effects of intraoperative DEX in children undergoing strabismus surgery from inception to October 2019. Read More

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The Effects of Intraoperative Caffeine on Postoperative Opioid Consumption and Related Outcomes After Laparoscopic Surgery: A Randomized Controlled Trial.

Anesth Analg 2021 May 3. Epub 2021 May 3.

From the Department of Anesthesiology.

Background: Surgical patients are vulnerable to opioid dependency and related risks. Clinical-translational data suggest that caffeine may enhance postoperative analgesia. This trial tested the hypothesis that intraoperative caffeine would reduce postoperative opioid consumption. Read More

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Postoperative Maladaptive Behavior, Preoperative Anxiety and Emergence Delirium in Children Undergone General Anesthesia: A Narrative Review.

Glob Pediatr Health 2021 7;8:2333794X211007975. Epub 2021 Apr 7.

Universiti Sains Malaysia, School of Medical Sciences, Kubang Kerian, Kelantan, Malaysia.

Over the years, the number of pediatric patients undergoing surgeries are increasing steadily. The types of surgery vary between elective to emergency with involvement of multidisciplinary teams. The development of day care surgery unit is expanding where the patients will only come to the hospital on the day of surgery and discharge home after such as satisfactory parameters achieved, minimal to no pain, minimal to no bleeding from surgical site and able to tolerate fluids. Read More

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Pediatric emergence delirium is linked to increased early postoperative negative behavior within two weeks after adenoidectomy: an observational study.

Braz J Anesthesiol 2021 Apr 19. Epub 2021 Apr 19.

Klinikum Dortmund, Department of Anesthesiology and Operative Intensive Care Medicine, Dortmund, Germany; University Hospital Bonn, Department of Anesthesiology and Operative Intensive Care Medicine, Bonn, Germany. Electronic address:

Background: The aim of this prospective multicenter observational study was to measure the incidence of postoperative pediatric emergence delirium and to investigate the occurrence of early postoperative negative behavior within two weeks after outpatient adenoidectomy in preschool children.

Methods: The study comprised 222 patients (1-7 years of age). All children received a multimodal anesthesia based on total intravenous anesthesia with propofol and remifentanil in combination with piritramid (0. Read More

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Emergence delirium in children: a Brazilian survey.

Braz J Anesthesiol 2021 Apr 3. Epub 2021 Apr 3.

Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clinicas (HC), Disciplina de Anestesiologia, Sao Paulo, SP, Brazil.

Background: Pediatric emergence delirium is characterized by a disturbance of a child's awareness during the early postoperative period that manifests as disorientation, altered attention and perception. The incidence of emergence delirium varies between 18% and 80% depending on risk factors and how it is measured. Reports from Canada, Germany, Italy, United Kingdom, and France demonstrated a wide range of preventive measures and definitions, indicating that there is a lack of clarity regarding emergence delirium. Read More

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Use of therapeutic caffeine in acute care postoperative and critical care settings: a scoping review.

BMC Anesthesiol 2021 Mar 31;21(1):100. Epub 2021 Mar 31.

Department of Intensive Care Services, Royal Brisbane and Women's Hospital and Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.

Background: Caffeine is the most utilised psychoactive drug worldwide. However, caffeine withdrawal and the therapeutic use of caffeine in intensive care and in the perioperative period have not been well summarised. Our objective was to conduct a scoping review of caffeine withdrawal and use in the intensive care unit (ICU) and postoperative patients. Read More

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Dexmedetomidine vs. total intravenous anaesthesia in paediatric emergence delirium: A network meta-analysis.

Eur J Anaesthesiol 2021 Mar 11. Epub 2021 Mar 11.

From the Department of Pediatric Anesthesia, Montreal Children's Hospital, McGill University, Montreal, Quebec (M-AP), Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (DNL, JTM, KA), Department of Anesthesiology and Pain Medicine, University of Toronto (DNL, JTM, KA), Library and Information Services, University Health Network (ME), Program in Molecular Medicine (JTM), and Program in Child Health Evaluative Sciences (PP, KA), SickKids Research Institute, Toronto, Ontario, Canada.

Background: Emergence delirium is a common complication in paediatric anaesthesia associated with significant morbidity. Total intravenous anaesthesia (TIVA) and intra-operative dexmedetomidine as an adjuvant to sevoflurane anaesthesia can both reduce the incidence of emergence delirium compared with sevoflurane alone, but no studies have directly compared their relative efficacy.

Objective: The study objective was to compare the effects of TIVA and dexmedetomidine on the incidence of paediatric emergence delirium. Read More

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Intraoperative clonidine to prevent postoperative emergence delirium following sevoflurane anesthesia in pediatric patients: a randomized clinical trial.

Braz J Anesthesiol 2021 Jan-Feb;71(1):5-10. Epub 2020 Dec 25.

Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Departamento de Anestesiologia, Recife, PE, Brazil. Electronic address:

Introduction And Objective: Emergence Delirium (ED), particularly in children, is characterized by mental confusion, irritability, disorientation, and inconsolable crying. ED prolongs the time required in the Post-Anesthesia Care Unit (PACU) and increases concern and anxiety in parents. The present study aimed to determine the effectiveness and safety of low-dose clonidine in preventing ED in children receiving sevoflurane anesthesia for tonsillectomy/adenotonsillectomy. Read More

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December 2020

Prehabilitative exercise hastens recovery from isoflurane in diabetic and non-diabetic rats.

Neurosci Lett 2021 04 8;751:135808. Epub 2021 Mar 8.

Neuroscience Program, Emory University, Atlanta, GA, USA; School of Medicine, Emory University, Atlanta, GA, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA; Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA. Electronic address:

Diabetes has been demonstrated to be one of the strongest predictors of risk for postoperative delirium and functional decline in older patients undergoing surgery. Exercise is often prescribed as a treatment for diabetic patients and regular physical activity is hypothesized to decrease the risk of postoperative cognitive impairments. Prior studies suggest that anesthetic emergence trajectories and recovery are predictive of risk for later postoperative cognitive impairments. Read More

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Evolution of COVID-19 management in critical care: review and perspective from a hospital in the United Kingdom.

Acute Crit Care 2021 Feb 26;36(1):1-14. Epub 2021 Feb 26.

Critical Care Unit, Royal Preston Hospital, Preston, UK.

The unexpected emergence and spread of coronavirus disease 2019 (COVID-19) has been pandemic, with long-lasting effects, and unfortunately, it does not seem to have ended. Integrating advanced planning, strong teamwork, and clinical management have been both essential and rewarding during this time. Understanding the new concepts of this novel disease and accommodating them into clinical practice is an ongoing process, ultimately leading to advanced and highly specific treatment modalities. Read More

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February 2021

Intranasal esketamine: From origins to future implications in treatment-resistant depression.

J Psychiatr Res 2021 May 19;137:29-35. Epub 2021 Feb 19.

University of Kentucky- Bowling Green, 250 Park St. Attn: GME, Bowling Green, KY, 42101, USA.

The approval of intranasal esketamine for treatment-resistant depression marks the next step in our understanding of and ability to treat treatment-resistant depression. The origin of ketamine is rooted in the search for a phencyclidine analog that could be used as a pre-surgical anesthetic with less emergence delirium. Following its inception, ketamine has been used in a variety of contexts. Read More

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The Use of Tablet Computers to Reduce Preoperative Anxiety in Children Before Anesthesia: A Randomized Controlled Study.

J Perianesth Nurs 2021 Feb 23. Epub 2021 Feb 23.

Department of Anaesthesiology and Intensive Care, University Hospital Odense, Odense, Denmark; Department of Clinical Research - Anaesthesiology, University of Southern Denmark, Odense, Denmark.

Purpose: Children undergoing surgery and general anesthesia often experience preoperative anxiety (POA) with related negative short-, medium- and long-term consequences. Anxiolytic premedication has negative side effects, and nonpharmacologic interventions are often resource demanding and not always readily available in a busy clinical setting. The use of an age-appropriate game on a tablet computer may reduce POA, postoperative pain, and occurrence of emergence delirium (ED). Read More

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February 2021

Incidence and Risk Factors of Emergence Delirium after Anesthesia in Elderly Patients at a Postanesthesia Care Unit in Ethiopia: Prospective Observational Study.

Patient Relat Outcome Meas 2021 9;12:23-32. Epub 2021 Feb 9.

Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Northwest Ethiopia, Ethiopia.

Introduction: Emergence delirium is a common incidental trouble in elderly patients that may interfere with patient recovery and will challenge the attending staff. So, we aimed to determine the incidence and risk factors of emergence delirium after anesthesia in elderly patients at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), Post Anesthesia Care Unit (PACU).

Methods: A prospective observational study was conducted from February 20 to May 20, 2020 among elective and emergency procedures in patients aged 60 years and over at UOGCSH, PACU. Read More

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February 2021

Preoperative Cognitive Impairment and the Prevalence of Postoperative Delirium in Elderly Cancer Patients-A Prospective Observational Study.

Diagnostics (Basel) 2021 Feb 10;11(2). Epub 2021 Feb 10.

Department of Anaesthesia and Intensive Care, School of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.

Preoperative cognitive impairment (PCI) in cancer patients includes a broad spectrum of neurocognitive changes produced by complex interplay of patient, tumoural and treatment-related factors. Reduced preoperative cognitive reserve can favour the emergence of postoperative delirium (POD). The study aims to document PCI prevalence and to assess the relationship with POD in elderly cancer patients. Read More

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February 2021

Anesthetic Management of Asleep and Awake Craniotomy for Supratentorial Tumor Resection.

Anesthesiol Clin 2021 Mar;39(1):71-92

Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Mail Code UH2, Portland, OR 97239, USA.

Understanding how anesthetics impact cerebral physiology, cerebral blood flow, brain metabolism, brain relaxation, and neurologic recovery is crucial for optimizing anesthesia during supratentorial craniotomies. Intraoperative goals for supratentorial tumor resection include maintaining cerebral perfusion pressure and cerebral autoregulation, optimizing surgical access and neuromonitoring, and facilitating rapid, cooperative emergence. Evidence-based studies increasingly expand the impact of anesthetic care beyond immediate perioperative care into both preoperative optimization and minimizing postoperative consequences. Read More

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Acupuncture for postoperative delirium (POD): A systematic review and meta-analysis protocol.

Medicine (Baltimore) 2021 Jan;100(3):e23822

Department of Acupuncture & Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital.

Background: Postoperative delirium (POD) is a form of delirium that is newly diagnosed after a surgical procedure. This study aims to examine the effectiveness and safety of acupuncture treatment for POD in patients who underwent surgery.

Methods: Randomized controlled trials for patients diagnosed with POD using validated delirium assessment scales will be included in this review. Read More

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January 2021

Clinical features of neurological patients with coronavirus 2019: an observational study of one centre.

Neurol Neurochir Pol 2021 2;55(2):195-201. Epub 2021 Feb 2.

Department of Neurology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Woloska street 137, 02-507 Warsaw, Poland.

Background: Since the emergence of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) in Wuhan, China, it has been extensively studied by many scientists. Susceptibility to SARS-CoV-2 infection is shown by people of all ages, especially those with different comorbidities. Our goal was to describe the clinical characteristics, treatment, course, and outcome of COVID-19 in patients with pre-existing neurological disorders. Read More

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Reducing Perioperative Neurocognitive Disorders (PND) Through Depth of Anesthesia Monitoring: A Critical Review.

Int J Gen Med 2021 14;14:153-162. Epub 2021 Jan 14.

Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.

General anesthesia has been administered for over 150 years, and in that time, has become progressively safer. Improvements in outcomes have been driven by multiple advances, including the use of non-invasive monitors to assess cardiovascular and respiratory status. More recent advances have included the development and use of monitors to measure neurologic status by means of "processed" electroencephalography (pEEG), wherein the frontal EEG signal is analyzed by proprietary algorithms to produce a dimensionless number (scaled from 0 to 100), wherein low values are associated with deepening levels of sedation that progresses to loss of consciousness. Read More

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January 2021

Efficacy and safety of caudal dexmedetomidine in pediatric infra-umbilical surgery: a meta-analysis and trial-sequential analysis of randomized controlled trials.

Reg Anesth Pain Med 2021 May 15;46(5):422-432. Epub 2021 Jan 15.

Anesthesia & Perioperative Medicine, Western University, London, Ontario, Canada

Background: Dexmedetomidine is used as a local-anesthetics adjuvant in caudal block to prolong analgesia in pediatric infra-umbilical surgery.

Objective: We evaluated the analgesic efficacy and safety of the addition of caudal dexmedetomidine to local anesthetics (vs local anesthetics alone) in pediatric infra-umbilical surgery.

Evidence Review: We searched 10 databases for randomized controlled trials (RCTs) of pediatric patients undergoing infra-umbilical surgery, comparing caudal block with and without dexmedetomidine as local anesthetic adjuvant. Read More

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Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review.

BMJ Open 2021 01 6;11(1):e043968. Epub 2021 Jan 6.

Department of Anesthesia and Pain Medicine, Hospital of Sick Children, University of Toronto, Toronto, Ontario, Canada

Objectives: Emergence delirium (ED) occurs in approximately 25% of paediatric general anaesthetics and has significant adverse effects. The goal of the current systematic review was to identify the existing literature investigating performance of predictive models for the development of paediatric ED following general anaesthesia and to determine their usability.

Design: Systematic review using the Prediction model study Risk Of Bias Assessment Tool (PROBAST) framework. Read More

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January 2021

Improving the Utility of Electroencephalogram-Guided Anesthesia for Prevention of Postoperative Delirium.

Anesth Analg 2021 01;132(1):e12

Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois,

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January 2021

An observational study of hypoactive delirium in the post-anesthesia recovery unit of a pediatric hospital.

Paediatr Anaesth 2021 Apr 7;31(4):429-435. Epub 2021 Feb 7.

Pediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Australia.

Background: Hypoactive delirium is present when an awake child is unaware of his or her surroundings, is unable to focus attention, and appears quiet and withdrawn. This condition has been well-described in the intensive care setting but has not been extensively studied in the immediate post-anesthetic period.

Aim: To determine if hypoactive emergence delirium occurs in the recovery unit of a pediatric hospital, and if so, what proportion of emergence delirium is hypoactive in nature. Read More

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Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study.

Clin Interv Aging 2020 18;15:2375-2381. Epub 2020 Dec 18.

Anesthesiology and Intensive Care Department, CHU Toulouse, Toulouse, France.

Background: After cardiac surgery, postoperative delirium (POD) is common and is associated with long-term changes in cognitive function. Impact on health-related quality of life (QOL) and long-term dependence are not well known. This aim of this study is to evaluate the role of POD in poor evolution at three years after surgery including poor QOL and dependence and mortality. Read More

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The Effect of Intraoperative Magnesium Sulphate Infusion on Emergence Agitation after Ambulatory Ophthalmic Surgery in Children.

J Clin Med 2020 Dec 21;9(12). Epub 2020 Dec 21.

Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.

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. Read More

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December 2020

Therapeutic Mechanisms of Ketamine.

Psychiatr Danub 2020 Autumn - Winter;32(3-4):325-333

Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia.

Major depressive disorder is the greatest burden of developed countries in the context of morbidity caused by mental disorders. Until recent, ketamine has been mostly used for anesthesia, analgesia, sedation and treatment of chronic pain syndromes. However, unique pharmacodynamic properties of ketamine have increased interests in it's use for treatment of depression. Read More

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January 2021

Risk factors for emergence agitation in adults after general anesthesia: A systematic review and meta-analysis.

Acta Anaesthesiol Scand 2020 Dec 28. Epub 2020 Dec 28.

Department of Anesthesia, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Emergence agitation (EA) is an adverse post-operative complication that increases the risk for injury, self-extubation, hemorrhages, and prolonged hospitalization. This meta-analysis aims to define the risk factors for adult EA after general anesthesia and provide recommendations for clinical practice.

Methods: Embase, PubMed, Medline, and the Cochrane Library databases were comprehensive retrieved. Read More

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December 2020

Preventive effect of ramelteon on emergence agitation after general anaesthesia in paediatric patients undergoing tonsillectomy: a randomised, placebo-controlled clinical trial.

Sci Rep 2020 12 15;10(1):21996. Epub 2020 Dec 15.

Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.

Purpose of this prospective, double-blind, parallel-group, placebo-controlled, randomised clinical trial was to confirm our hypothesis that ramelteon has a preventive effect on emergence agitation after general anaesthesia in children. Patients aged 18 to 119 months (ASA physical status 1 or 2), scheduled to undergo tonsillectomy under general anaesthesia, were randomly allocated to the ramelteon or placebo group. Before general anaesthesia induction, patients in the ramelteon group received 0. Read More

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December 2020

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment.

BMJ Case Rep 2020 Dec 13;13(12). Epub 2020 Dec 13.

Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Read More

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December 2020

Behavioral and Emotional Disorders in Children and Their Anesthetic Implications.

Children (Basel) 2020 Nov 25;7(12). Epub 2020 Nov 25.

Division of Anesthesiology, Pain and Perioperative Medicine-Children's National Hospital, The George Washington University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA.

While most children have anxiety and fears in the hospital environment, especially prior to having surgery, there are several common behavioral and emotional disorders in children that can pose a challenge in the perioperative setting. These include anxiety, depression, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder, post-traumatic stress disorder, and autism spectrum disorder. The aim of this review article is to provide a brief overview of each disorder, explore the impact on anesthesia and perioperative care, and highlight some management techniques that can be used to facilitate a smooth perioperative course. Read More

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November 2020

Effect of magnesium supplementation on emergence delirium and postoperative pain in children undergoing strabismus surgery: a prospective randomised controlled study.

BMC Anesthesiol 2020 11 18;20(1):289. Epub 2020 Nov 18.

Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, # 101 Daehakno, Jongnogu, Seoul, 03080, Republic of Korea.

Background: The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anaesthesia on emergence delirium and postoperative pain in children were evaluated.

Methods: A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Read More

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November 2020