A Prospective Cohort Study of Emergence Agitation in the Pediatric Postanesthesia Care Unit

Abstract

Children may become agitated after general anesthesia. This study describes several factors that may increase the risk for agitation. These data are important in planning anesthesia care for young children.

Comparison of the effects of dexmedetomidine, ketamine, and placebo on emergence agitation after strabismus surgery in children

“…24 Early epidemiologic studies reported widely varying incidences of EA in children, ranging from 10-80%. 25,26 Although the precise etiology of EA is currently unknown, suggested risk factors include pain, preschool age, the type of otolaryngologic or ophthalmologic procedure performed, and the use of sevoflurane or desflurane. 25,26 It has been reported that the incidence of POV in children is twice as high as in adults, and age [ 3 yr has been proposed as an independent risk factor for POV.…”

Research on emergence agitation in children

“…It is well established that strabismus surgery in children is complicated by a high incidence of emergence agitation (EA). 2 It has also been well established that propofol-based anesthetic techniques and/or techniques that include low doses of opioids or sedative hypnotics can significantly decrease the incidence of EA. 3 In their study, Chen et al evaluated outcomes in children undergoing eye muscle surgery who received no propofol, sedatives, or parenteral analgesics during the study period.…”

Agitação no despertar da anestesia em crianças: aspectos atuais

“…5,11 When children are separated from their parents and sent to the operating room alone, this is traumatic and increases the risk of emergence agitation. 12 Experimental research has demonstrated that separating mother rats from their young during the preoperative period triggered postoperative agitation.…”

“…11,20 It is speculated that the sensation of suffocation in otorhinolaryngological procedures may be responsible for these events; although scientific evidence indicating that this is a causative factor of agitation is scarce and inconsistent.…”

“…[21][22][23] Other inhaled anesthetics, such as desflurane and isoflurane, have also been linked with the occurrence of emergence agitation. 11,24 Emergence agitation incidence rates of 50 to 80% have been observed when desflurane was being used. 24 Emergence agitation was detected in 2/3 of patients who underwent myringotomy for ventilation tube placement under anesthesia with sevoflurane.…”