Congenital melanocytic nevi need surgical excision. However, the effect of size and location of nevi on pain and emergence agitation have yet to be studied. The objective of this study was to evaluate (1) the ideal parameter of nevus size and (2) the effects of size and location of nevus on pain and emergence agitation.
This observational study enrolled 100 children scheduled for excision of nevus under sevoflurane anesthesia. Parameters of nevus size included long diameter, area before resection, area of resection, and proportion (area of resection/total body surface). Nevus locations included trunk, face, scalp, and extremities.
Proportion of nevi was the most ideal parameter in evaluating the pain and emergence agitation. A large size showed higher emergence agitation than a small size (median [range]; 6 [0-20] in small group vs. 12.5 [0-20] in large groups, p = 0.021). However, the pain was comparable. Nevus location did not influence pain or emergence agitation. In multivariate regression analysis, younger age and extensive excision were associated with higher pain and emergence agitation.
In conclusion, large nevi induced more severe emergence agitation. However, nevus location did not affect the outcome. In addition, younger age was associated with pain and emergence agitation. Clinicians need to consider the proportion of nevi when managing children undergoing nevus excision.
