It is well known that sevoflurane anesthesia is associated with emergence agitation (EA) in children, and that fentanyl may reduce its incidence. However, in case of midazolam, there have been conflicting reports. Therefore, we measured the effect of midazolam on EA after sevoflurane anesthesia and compared it with that of fentanyl.

Sixty pediatric patients receiving sevoflurane anesthesia for tonsillectomy was assigned to 3 groups. Saline 0.1 ml/kg (group P), midazolam 0.1 mg/kg (group M), or fentanyl 1 µg/kg (group F) was administered intravenously 10 minutes before the end of surgery. The incidences of over-sedation (OS) and EA were checked three times at the postanesthesia care unit.

Group M had a tendency to show a high incidence of OS, but its incidence of EA was not different from the other groups. In group F, OS and EA were less frequent than in groups P and M.

After sevoflurane anesthesia for tonsillectomy, fentanyl effectively prevented EA, but midazolam elicited OS and was ineffective at preventing EA.