Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 11 Supp. 1 2025 04 23 635 639 Majid Razavi Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Hamideh Zarezadeh Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Ahmad Bagherimoghaddam Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Mehryar Taghavi Gilani Lung Diseases Research Center, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. 2025 03 01 2025 03 06 Background: Postoperative emergence agitation in children is so common. Isoflurane and propofol are evaluated for agitation, but results were contradictory. This study aimed to compare the effect of isoflurane and propofol for emergence agitation in children under three years old. Methods: This double-blinded, randomized clinical trial was performed on 104 children under three years’ old who were candidates for nasolacrimal probing. The children were anesthetized by sevoflurane and then were divided into isoflurane and propofol groups. After transfer to the recovery room, at first, 4 and 8 minutes, the degree of agitation of the child was measured according to the Watcha sedation criteria. Results: The demographic parameters were not different. The mean duration of anesthesia (from LMA insertion to extubation) in isoflurane was significantly shorter than in propofol (p = 0.001). Also, the recovery time in the isoflurane group was significantly shorter than that of the propofol group (P=0.02). The prevalence of agitation was 7.69% in the propofol and 59.61% in the isoflurane, and the difference was significant (P = 0.001). Agitation scores at first, 4 and 8 minutes in the recovery room, showed less agitation in the propofol group (P=0.001). Conclusion: Our study showed that propofol in children reduces the incidence of emergence agitation compared to isoflurane. But emergence and recovery time in the isoflurane group was less than in the propofol group. https://aacc.tums.ac.ir/index.php/aacc/article/view/1220