The Impact of Administration of Chlorpheniramine/Paracetamol versus Paracetamol Only on the Postoperative Agitation after Orofacial Cleft Repair Procedures in Pediatrics

Background term “emergence delirium” first appeared in medical literature in early 1960s. While it is frequently used interchangeably with emergence agitation, it is described as temporary dissociated state of consciousness following anaesthesia discontinuation. Aim and Objectives aim was to study the role of pre-emptive Chlorpheniramine as an adjuvant to paracetamol in the prevention of emergence agitation in orofacial cleft repair surgeries. Studied cases& techniques: study was prospective, Randomized, Double-Blind Clinical research done at Ain-shams University Hospitals, Cairo, Egypt for 6 months after Medical Ethical Committee approval for children within 3 month up to 18 years with cleft lip or/with cleft palate. Results On comparison of facial express score between group A & group B, group A showed significant decrease in facial express score compared to group B as the median (IQR) facial express score in group A was 2.0 (2.0- 4.0) and 4.0 (2.0-8.0) in group B. Conclusion We deduced that preoperative chlorpheniramine 0.2 mg/kg and paracetamol 15mg/kg before skin incision is effective medication that can be used to stop or decrease severity of emergence agitation while causing minimal cardio- respiratory depression. It also enhanced quality of healing in post-anesthesia care unit.