BACKGROUND: Sevoflurane has a higher incidence of emergence agitation (EA) in children. We examined the effect of IV lidocaine doing the incidence of EA and the severity of postoperative pain in children who received sevoflurane anesthesia. METHODS: Eighty five children aged 2-7 years undergoing sevoflurane anesthesia were studied. Patients were randomly assigned to one of the two groups: Group C (n = 42) wherein subjects received saline solution, and Group L (n = 43) where they received 1.5 mg/kg of IV lidocaine 5 minutes before emergence from anesthesia. The recovery time, EA score, CHEOPS score and modified Aldrete postanesthesia score were repeatedly measured at the postanesthesia care unit (PACU). RESULTS: The time until first cough was significantly longer in group L. The EA score and CHEOPS score were not significantly different between the two groups. There was no significant difference in the use of additional analgesics or sedatives for treatment of severe EA or severe pain. CONCLUSIONS: After sevoflurane anesthesia, 1.5 mg/kg of IV lidocaine 5 minutes before extubation did not reduce the incidence of EA and the severity of postoperative pain. The time to discharge from the PACU was similar to that with placebo.