Emergence delirium in children

Abstract

Emergence delirium in children is a frequent but preventable complication. Strategies for prevention and therapy include particularly pain management and medication with alpha-2 agonists.

Postanaesthetic emergence agitation in adult patients after general anaesthesia for urological surgery

“…A long duration of surgery, history of social drinking, presence of a gastric tube, chronic lung disease and severe postoperative pain were predictive of emergence agitation. Studies regarding postoperative emergence agitation have evaluated paediatric patients in the operating room or the PACU, [10][11][12] and few have examined adult patients in either setting. The overall incidence of emergence agitation was reported to be 5% in two large-scale PACU-based prospective studies using the Riker sedation-agitation scale and Richmond agitation and sedation scale, respectively.…”

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

“…However, it has repeatedly reported that sevoflurane is associated with a high incidence (up to 80%) of emergence agitation in children [6]. Furthermore, Dahmani et al [7] has stated that pediatrics undergoing cataract surgery suffered from higher incidence of postoperative emergence agitation compared with other surgeries because of disturbed vision and eye patching upon awaking. Emergence agitation, including restlessness, disorientation, and inconsolable crying, may lead to suture dehiscence and raise intraocular pressure after cataract surgery [8].…”

Risperidone in a child with untractable emergency delirium: a case report

“…The etiology of ED is still unknown but is thought to be multifactorial and to include postoperative pain and the pharmacokinetics and pharmacodynamics of anesthetic agents [4]. Many ED risk factors, such as the child's age, ethnicity, socioeconomic background, temperament, previous hospital experience, anxiety level, and the length and type of procedure, have been reported in previous studies [14789].…”

“…If pediatric patients show ED-like behaviors in the PACU, the staff will usually administer sedative or opioid agents to calm them [14]. However, many of the clinical symptoms of ED are similar to those of paradoxical midazolam reactions [256].…”