Table 1 Clinical characteristics of the included studies
Study | Sample size | ASA | Age | Sex (M/F) | Type of surgery | Anesthetic agents | Postoperative analgesia | Melatonin dosage | Diagnosis tool for EA | Control | Foundation |
|---|---|---|---|---|---|---|---|---|---|---|---|
Ali [11] 2020 | 105 | 1 to 2 | 3 to 8 years | 91/14 | Elective infraumbilical surgical procedure | Induce: propofol + fentanyl+atracurium; Maintain: sevoflurane + N2O; | Paracetamol | 0.2 mg kg− 1 | Watcha scale | Dexmedetomidine or clonidine | Not mentioned |
Jangra [10] 2022 | 120 | 1 to 2 | 3 to 9 years | 75/45 | Ophthalmic surgery | Induce: sevoflurane+fentanyl; Maintain: sevoflurane + N2O; | Fentanyl for postoperative pain rescue | 0.5 mg kg− 1 | PAED scale | Dexmedetomidine | Departmental funds |
Kain [22] 2009 | 148 | 1 to 2 | 2 to 8 years | 82/66 | Outpatient elective surgery | Induce: sevoflurane + N2O; Maintain: not mentioned; | Not mentioned | 0.05, 0.2, 0.4 mg kg− 1 | Keegan scale (3-point scale) | Midazolam | Not mentioned |
Khalifa [23] 2013 | 60 | not reported | 3 to 6 years | 31/29 | Not reported | Induce: sevoflurane + cisatracurium; Maintain: sevoflurane; | Paracetamol | 0.1 mg kg− 1 | Five-point scale | Placebo (saline) | Not mentioned |
Komazaki [15] 2020 | 48 | 1 to 2 | 18 to 119 months | 37/11 | Tonsillectomy | Induce: sevoflurane + N2O +fentanyl+rocuronium; Maintain: sevoflurane; | Paracetamol | 0.1 mg kg− 1 | PAED scale, Aono’s scale | Placebo (syrup) | National Funds |
Ozcengiz [24] 2011 | 100 | 1 to 2 | 3 to 9 years | 50/50 | Oesophageal dilatation procedures | Induce: sevoflurane + N2O+vecuronium; Maintain: sevoflurane + N2O; | Paracetamol | 0.1 mg kg− 1 | EAS (4-point scale) | Placebo (saline), midazolam, or dexmedetomidine | Not mentioned |
Samarkandi [7] 2005 | 75 | 1 | 2 to 5 years | 50/25 | Minor elective surgery | Induce: sevoflurane + N2O; Maintain: sevoflurane + N2O; | Paracetamol + caudal block | 0.1, 0.25, 0.5 mg kg− 1 | Pain/discomfort scale (0 to 6 points) | Placebo (acetaminophen)a or midazolam | Departmental funds |
Singla [9] 2021 | 132 | 1 to 2 | 3 to 8 years | 93/39 | Elective ambulatory procedure | Induce: sevoflurane + N2O + fentanyl; Maintain: sevoflurane + N2O; | Fentanyl or regional block if required | 0.3 mg kg− 1 | Watcha scale | Placebo (honey) or midazolam | Departmental funds |
Song [25] 2020 | 163 | 1 to 2 | 2 to 6 years | 99/64 | Elective adenotonsillectomy or adenoidectomy | Induce: propofol + fentanyl + succinylcholine; Maintain: sevoflurane + N2O | Ketorolac | 0.5 mg kg− 1 | PAED scale | Placebo (syrup) or midazolam | Not mentioned |