Effect of Caffeine on the Acceleration of Emergence from General Anesthesia with Inhalation Anesthetics in Children Undergoing Inguinal Herniorrhaphy: A Randomized Clinical Trial

Background: Awakening following general anesthesia (GA) is one of the most important concerns of anesthesiologists in their daily work. Previous studies on adult humans found that caffeine could accelerate awakening after anesthesia. This study aimed to determine whether or not caffeine can accelerate awakening after anesthesia in children undergoing inguinal herniorrhaphy under GA. Methods: In this randomized clinical trial, we enrolled 18 children undergoing inguinal herniorrhaphy under GA with inhaled anesthetics from June 2019 to September 2019 in the tertiary hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). These children were randomly allocated to two groups. In group A, the children received intravenous caffeine (10 mg/Kg) at the end of the surgery, and in group B, the children received intravenous normal saline at the end of the surgery. The primary outcome was laryngeal mask airway (LMA) removal time at the end of anesthesia. Intra-operative hemodynamic data and side effects such as nausea, vomiting, dysrhythmia, cyanosis, and seizures in the recovery room were recorded and compared between the two groups. We used the independent-samples t test, Fisher's exact test, and repeated measures ANOVA for analyzing the data. P values<0.05 were considered statistically significant. Results: There were no significant differences in terms of demographic characteristics and hemodynamic data between the two groups. Furthermore, the time from the induction of anesthesia to laryngeal mask removal was 44.77 +/- 7.87 min in the placebo group and 44.55 +/- 10.68 min in the caffeine group. Therefore, there was no significant difference between the two groups (P=0.961). Conclusion: In children undergoing inguinal herniorrhaphy under GA, 10 mg/Kg of caffeine could not accelerate awakening from GA. However, caffeine did not increase the blood pressure and heart rate in the children, and no significant side effects were observed.