Elaborate study design leads to improved conclusion

care of surgical patients with temporary mental dys-function is one of the biggest challenges for the anesthesiologist in the recovery room. This temporary mental dysfunction presents with two different faces: one is emergence agitation (EA) in pediatric patients and the other is delirium in geriatric patients. EA is the clinical condition of pediatric patients who are suffering from temporary mental dysfunction after general anesthesia. It is a transient dysfunction of the brain. However, it is essential to differentiate EA from the similar condition of agitation due to insufficient pain control in the recovery room. The clinical presentations of EA and agitation due to pain are so similar in presentation that differentiation of the two conditions is very difficult in pediatric patients. Furthermore, the sedation caused by anesthetic drugs is another contributing factor to the onset and degree of EA. Sedation resulting from anesthetic drugs can mask or delay the onset of EA. If we wish to study the effect of a test drug on EA in pediat-ric patients in the recovery room, it is necessary to prove that there are no differences in the degree of agitation resulting from insufficient pain control and sedation from residual anesthetics between the control and experimental group. If this is not done, it would be very difficult to interpret the results in relation to EA in the experimental group. Particularly, if the test drug has significant greater sedative effect compared to the control drug, it would be impossible to calculate how much the test drug had contributed to the onset and degree of EA, reflected in the EA scores, in the children. In the case of agitation due to incomplete pain control, regional anesthesia or use of the same amount of painkiller would provide proof of the same degree of pain in the pediatric patients in the recovery room. In addition, the sedation score would be a better parameter to use to demonstrate the same degree of sedation in the two groups. A recent paper studied EA in pediatric patients in the recovery room. The title of the article is " A comparison of postoperative emergence agitation between sevoflurane and thiopental anesthesia induction in pediatric patients " (Korean J Anesthesiol 2015 Aug; 68(4): 373-378). In terms of the two factors mentioned above, some questions arise regarding the results of this paper. Although the author discussed his rationale for using the different EA scales, a …