Background:Emergence agitation (EA), although well documented in the clinical literature, still has uncertainties and confusion abound on this subject because of the absence of a clear definition and lack of reliable and valid assessment tools.Aim:To compare the incidence and severity of EA and recovery characteristics in paediatric patients under isoflurane, sevoflurane or desflurane anaesthesia and evaluate the effect of age and duration of anaesthesia on the incidence of EA.Settings and Design:Randomized prospective double-blinded study.Methods:Seventy-five American Society of Anaesthesiologists I and II patients, aged between 4 months and 7 years, were included in the study. Patients were induced with sevoflurane and oxygen. Anaesthesia was maintained with O2 + N2O and isoflurane, sevoflurane or desflurane according to randomization. Caudal block and paracetamol suppository was administered before the surgical incision. In the Post-Anesthesia Care Unit (PACU), degree of agitation was assessed using the Paediatric Anaesthesia Emergence Delirium Scale. Aldrette score, Face, Legs, Activity, Cry, Consolability score and any adverse events were noted.Statistical Analysis:Chi-square/Fischer exact test was applied for categorical variables; for continuous variables, the analysis of variance/non-parametric Kruskall–Wallis test was applied. Two-sample t-test/non-parametric Wisconsin Mann–Whitney test was applied between the two groups. Statistical significance was determined at P<0.05.Results:Incidence and intensity of EA were comparable in all three groups. Age and duration of anaesthesia do not appear to have any bearing on the incidence of EA. Rapid emergence with sevoflurane and desflurane did not translate into early discharge from PACU.Conclusions:EA is a multifactorial syndrome. More well-conducted studies using validated scales and standardized protocols should be carried out to better understand this phenomenon.

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The total conversion and the oil yield in liquefaction tests of iron ion-exchanged Black Thunder coal were found to increase by up to 23 and 18%, respectively, relative to the untreated coal. The ion-exchanged coal samples were prepared by stirring a slurry mixture of the coal and ferric acetate [Fe(OOCCH3)3] in a 10-L fermenter. The ion-exchange process, in which iron was exchanged primarily for calcium and magnesium, yielded a highly dispersed catalytic iron species for coal liquefaction. 57Fe Mossbauer and X-ray absorption fine structure (XAFS) spectroscopies and electron probe microanalysis (EPMA) X-ray mapping were used to characterize this iron species after the ionexchange process. The results indicate that the added iron is present in bimodal form. The majority of the iron is present as oxyhydroxide particles ranging from 25 to 100 A in diameter, while the smaller fraction is believed to be molecularly dispersed ferric ions held at ion-exchange (carboxyl) sites. With sufficient sulfur present in the system, the iron is rapidly transformed to pyrrhotite (Fei_*S) during liquefaction.indicate that the added iron is initially present in bimodal

Isoflurane and sevoflurane anaesthesia resulted in similar clinical and neurocognitive recovery profiles in older patients undergoing ambulatory surgical procedures of short duration.

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