الفهرس 
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Abstract
Emergence delirium (ED) was first described in the literature in the early 1960s. Although often used interchangeably with emergence agitation, it is defined as a temporary dissociated state of consciousness after discontinuation of anaesthesia.
Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Together, these birth defects commonly are called “orofacial clefts”. Cleft palate and cleft lip are common congenital malformation in children. The American Cleft Palate Craniofacial Association recommends that primary cleft palate surgery should ideally be performed within 12-18 months after birth and cleft lip repair should specifically deferred until the child is 10 pounds in weight, at or after 10 weeks of age, with a hemoglobin concentration of 10 g/dL.
Emergence agitation (EA) involves restlessness, disorientation, excitation, non-purposeful movement, inconsolability, thrashing, and incoherence during early recovery from general anesthesia. The mechanism of EA remains unclear.
The emergence agitation has clinically significant consequences which are typically short lived and resolves spontaneously. That may include injury to the affected patient or their medical staff, falling out of bed, bleeding at the surgical site, accidental removal of drains or intravenous catheters, unintended extubation, respiratory depression, and increasing medical care costs.
The aim was to study the role of pre-emptive Chlorpheniramine as an adjuvant to paracetamol in the prevention of emergence agitation in orofacial cleft repair surgeries.
This study was a prospective, randomized, double-blinded clinical study done at Ain-shams University Hospitals, Cairo, Egypt for 6 months after Medical Ethical Committee approval for children within 3 month up to 12 years with cleft lip or/with cleft palate.
Approval was obtained from the research ethics committee of Faculty of Medicine; Ain Shams University and a written informed consent was taken from each patient’s parents or guardian to participate in the study.
In our results, no statistically significant difference was observed between the two groups regarding age, gender or weight, ASA physical status, surgery duration or anesthesia or respiratory rate/min at extubation and hemodynamics.
On other hand, comparison of RASS, facial expression scale and postoperative complication (laryngospasm, desaturation and nausea and vomiting) between group A and group B, group A showed significant decrease in comparison to group B.