Effect of Controlled versus Spontaneous Ventilation on Postoperative Emergence Agitation in 2-4-Year-Old…

Randomized trialMedical journal of the Islamic Republic of Iran· 2026

Effect of Controlled versus Spontaneous Ventilation on Postoperative Emergence Agitation in 2-4-Year-Old Children Undergoing Adenotonsillectomy: A Double-Blind Randomized Clinical Trial.

Taymaz Amiraslani, Salumeh Sehat Kashani, Mohammad Ghaemi … Mahya Sabouri

Pediatric AnesthesiaRandomized trialTreatmentQ3IF 1.0

Controlled ventilation cuts emergence agitation vs spontaneous breathing in young children

Effect of Controlled versus Spontaneous Ventilation on Postoperative Emergence Agitation in 2-4-Year-Old Children Undergoing Adenotonsillectomy: A Double-Blind Randomized Clinical Trial.

Taymaz Amiraslani … Mahya Sabouri

Medical journal of the Islamic Republic of Iran · 2026 · Q3 in General Medicine

Background

Emergence agitation (emergence agitation), characterized by restlessness and inconsolable behavior, is a common postoperative complication in children after sevoflurane anesthesia, potentially causing secondary injuries and prolonged PACU stays.

Purpose

This study aimed to compare the effects of controlled mechanical ventilation (controlled mechanical ventilation) versus spontaneous ventilation (spontaneous ventilation) on emergence agitation, pain, recovery time, and related outcomes in children aged 2-4 years undergoing adenotonsillectomy.

Methods

Were randomized to controlled mechanical ventilation (controlled mechanical ventilation) or spontaneous ventilation (spontaneous ventilation) during emergence.

n = 79 children

Results

agitation scores were lower with controlled ventilation than spontaneous breathing

CMV

0.6RASS s

SV

1.21RASS s

More results

Oxygen saturation, neuromuscular monitoring, and postoperative nausea were comparable between groups.

No delirium cases were observed.

“

Conclusion · 1 of 2

Controlled mechanical ventilation significantly reduces emergence agitation, postoperative pain, and PACU stay duration compared with spontaneous ventilation in children undergoing adenotonsillectomy, likely by preventing hypercapnia and stabilizing physiological parameters.

Conclusion · 2 of 2

controlled mechanical ventilation is recommended as the preferred ventilation strategy in this population, while the absence of delirium confirms the low inherent neurological risk in children less than 5 years.

Effect of Controlled versus Spontaneous Ventilation on Postoperative Emergence Agitation in 2-4-Year-Old Children Undergoing Adenotonsillectomy: A Double-Blind Randomized Clinical Trial.

Effect of Controlled versus Spontaneous Ventilation on Postoperative Emergence Agitation in 2-4-Year-Old Children Undergoing Adenotonsillectomy: A Double-Blind Randomized Clinical Trial.

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