Delirium and Pain after Strabismus Surgery in Children Undergo General Anesthesia: A Comparison of Paracetamol and Meperidine

Strabismus surgery under general anesthesia is one of the most common ophthalmic procedures in children with emergence delirium as an important post-operative complication. Additionally, postoperative pain is another important issue which is considered as a contributing factor to emergence delirium. We conducted a study to compare meperidine with paracetamol on postoperative pain and emergence delirium.
This double blind randomized clinical trial was carried out on 60 children underwent elective strabismus surgery under general anesthesia. Patients were randomly allocated in two groups of 30 that received intravenous meperidine (1mg/kg) or paracetamol (15 mg/kg). Severity of pain were assessed one minute after extubation and every 5 minutes up to 1 hour by using CHEOPS and PAED was used for assessment of emergence delirium by time interval of every 10 minutes up to 30 minutes. Other complications such as bronchospasm, laryngospasm, nausea and vomiting were also recorded.
Pain severity was significantly higher is in paracetamol group while in meperidine group no patients received additional fentanyl in recovery room and emergence delirium was lower 30 minutes after surgery.
Although meperidine and paracetamol are both effective in reducing incidence of emergence delirium and controlling postoperative pain after strabismus surgery, meperidine is significantly more efficient.