PROPOFOL THIOPENTAL MIDAZOLAM CLONIDINE Prevention of Emergence Agitation Treatment of Emergence Agitation OPIOIDS NOTHING OTHER RESTRAINT PARENTS MIDAZOLAM OPIOIDS CLONIDINE PROPOFOL

Editor—Emergence agitation is a topic of clinical interest since the introduction of sevoflurane and desflurane, and it remains oneoftheunansweredquestionsforthepaediatricanaesthetist. The incidence is reported to be between 10% and 80% depending on definition and evaluation scale used. Emergence agitation, although self-limited, may require physical restraint and is a considerable source of distress for the child, the parents, and the medical staff. We conducted an identical survey in two European countries with a different paediatric anaesthesia set-up in order to better understand the current perception and approach. After approval by the scientific committees of the Italian Paediatric Society of anaesthesia, analgesia and intensive care (SIAATIP) and the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI), all European members (851 in total) were invited to take part in a web-based survey consisting of 10 multiple choice questions. A total of 305 questionnaires (response rate 21%) were returned and these indicated a considerable difference among the responders from the two societies regarding their caseload. Fifty-eight per cent of responders from the APAGBI were fulltime paediatric anaesthetists compared with only 14% of the Italian SIAATIP participants. More than 50% of responders from both countries had a working experience of more than 10 yr. The personal incidence of emergence agitation was estimated ,10% in both countries and half of respondents from both countries felt distressed by this phenomenon. There was a large difference regarding prevention and treatment of emergence delirium (Fig. 1). While the majority of Italy-based respondents gave midazolam as first