Background: Emergence agitation (EA) in children is one of the most common complications following anaesthesia. We aimed to compare the effect of ketamine, ketaminemidazolam and ketamine-propofol on EA after tonsillectomy. Methods: This study was a randomised, double-blind clinical trial conducted on 162 children undergoing adenotonsillectomy surgery. The participants were randomly divided into three groups of receiving ketamine (0.5 mg/kg) (N = 54), ketamine (0.5 mg/kg) + propofol (1 mg/kg) (N = 54) and ketamine (0.5 mg/kg) + midazolam (0.01 mg/kg) (N = 54) 10 min before the end of the operation. At the time of the patients’ entry into the post-anaesthesia care unit (PACU) and at intervals of 5 min, 10 min and 20 min after that, consciousness, mobility, breathing, circulation and SpO2 were recorded. Modified Aldrete recovery score (MARS), the objective pain score (OPS) and Richmond agitation-sedation scale (RASS) were also evaluated. Results: At the time of entrance to the PACU and 5 min later, the ketamine-midazolam and ketamine-propofol groups had lower RASS scores than the ketamine group (P < 0.001); after 10 min and 20 min, the ketamine-propofol group showed the lowest RASS score (P < 0.001). Ketamine-propofol group had a significantly lower MARS score at all-time points (P < 0.001). Recovery time was the longest for the ketamine-propofol group (P = 0.008). Conclusion: The ketamine-midazolam group had lower RASS, greater haemodynamic stability and MARS values without delayed awakening.

Background: Pre-operative anxiety is a universal reaction experienced by patients who are admitted to hospitals for surgery. The present study aimed to assess the causes of anxiety and concerns about anesthesia in adults undergoing surgery. Methods: This cross-sectional study was conducted in Dastgheyb and Mother and Child Hospitals, Shiraz, in 2015. The data were collected using a demographic information form and a questionnaire including questions about the patients' fears from anesthesia. Besides, the patients were required to score their anxiety from 0 to 10 in a specific form. An expert also measured the patients' anxiety levels using a standard visual analog scale ranging from 0 to 10. Results: Totally, 72 of the 74 distributed questionnaires were completed (response rate: 97%). The results showed that the patients with more than 12 years of education, below 40 years of age, in the very important person section, and working in non-medical jobs, females, and single patients were more afraid of anesthesia. Besides, the results of Pearson's correlation coefficient revealed a significant positive relationship between the anxiety scores reported by the patients and the expert (r = 0.813, P < 0.001). Conclusion: Identification of the causes of anxiety and concerns about anesthesia could be useful for designing specific preventive interventions to relieve patient suffering.