Should sevoflurane be used for maintenance of anaesthesia in children?

Sevoflurane is used for inhalational induction of anaesthesia because of its pleasant odour and quick onset. However, its use for maintenance of anaesthesia in children has been questioned because of the risk of emergence delirium. Emergence delirium is defined by Sikich and Lerman (2004) as a disturbance in awareness of, and attention to, the environment with disorientation and perceptual alterations including hypersensitivity to stimuli and hyperactive motor behaviour in the immediate post-anaesthesia period. Its incidence is between 10 and 80% following general anaesthesia, and it has the potential to cause injury to the child or care provider, may cause intravenous lines or drains to become dislodged, often requires additional nursing support and delays recovery time (Vlajkovic and Sindjelic, 2007).