Evidence map›Paper›PMID 41593385›Full record

SynthesisPediatric research2026

Relationship between perioperative medications and risk of emergence agitation in children after sevoflurane anesthesia: a network meta-analysis.

Saihao Fu, Mengrong Miao, Jing Bian, Yunxiang Fu, Jiaqiang Zhang, Mingyang Sun

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Saihao Fu *Department of Anesthesiology and perioperative medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
Mengrong Miao *Department of Anesthesiology and perioperative medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
Jing BianDepartment of Anesthesiology and perioperative medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China.
Yunxiang FuDepartment of Anesthesiology and perioperative medicine, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China.
Jiaqiang ZhangDepartment of Anesthesiology and perioperative medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China. Jiaqiang197628@163.com.
Mingyang SunDepartment of Anesthesiology and perioperative medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China. mingyangsun1986@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo explore the efficacy of perioperative medications in preventing emergence agitation (EA) in children after sevoflurane anaesthesia.

methodsThis network meta-analysis used a frequency-analysis model. PubMed, Embase, Cochrane Library, Web of Science, Google Scholar and ClinicalTrials.gov databases were searched from inception to March 11, 2023.

resultsA total of 19 drugs were analysed in 70 studies involving 7617 participants. In the cumulative ranking area under the curve (SUCRA) analysis, sufentanil, esketamine, dexmedetomidine, nalbuphine, tropisetron, ketamine, magnesium sulphate, propofol, fentanyl, remifentanil, and midazolam showed significant EA-preventing effects. Further direct comparisons between the drugs and the control group revealed that fentanyl (Log OR = -1.28, 95% CI -1.76, -0.80, P < 0.001), ketamine (Log OR = -1.77, 95% CI -2.45, -1.10, P < 0.001), dexmedetomidine (Log OR = -1.60, 95% CI -1.88, -1.33, P < 0.001), midazolam (Log OR = -0.96, 95% CI -1.34, -0.57, P < 0.001), propofol (Log OR = -1.34, 95% CI -1.83, -0.85, P < 0.001), and nalbuphine (Log OR = -1.32, 95% CI -1.66, -0.98, P < 0.001) significantly reduced the incidence of EA in children.

conclusionDexmedetomidine, propofol, midazolam, fentanyl, nalbuphine, and ketamine showed favourable EA-preventing effects in children. REGISTRATION NUMBER: CRD42023470892. IMPACT: This review provides a detailed network meta-analysis comparing 19 perioperative medications, offering a ranked efficacy profile (via SUCRA analysis) for preventing emergence agitation (EA) in children after sevoflurane anaesthesia, which consolidates and expands upon previous pairwise comparisons. It identifies dexmedetomidine, propofol, midazolam, fentanyl, nalbuphine, and ketamine as the most effective drugs for EA prevention, supporting evidence-based decision-making in paediatric anaesthesia practice.

Identifiers

PMID41593385

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.