Emergence delirium, pain or both? a challenge for clinicians

Somaini, Marta; Sahillioğlu, Emre; Marzorati, Chiara; Lovisari, Federica; Engelhardt, Thomas; Ingelmo, Pablo

doi:10.1111/pan.12580

Cited by 52 publications

(45 citation statements)

References 19 publications

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“…The constructors of the PAED scale thus considered that the 2 items “The child is restless” and “The child is inconsolable” would reflect pain as well as ED . However, later, Somani et al found that in the first 15 minutes after awakening from general anesthesia, neither of these 2 items were reliable for identifying pain or ED . In our study, there were differences in the means and medians (Table ) when comparing the first 3 items with the last 2 items(Table ).…”

Section: Discussionmentioning

confidence: 99%

A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Ringblom

Wåhlin

Proczkowska

2018

Pediatric Anesthesia

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The one-factor solution and the satisfactory reliability in terms of internal consistency and stability support the use of the Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability.

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Section: Discussionmentioning

confidence: 99%

A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Ringblom

Wåhlin

Proczkowska

2018

Pediatric Anesthesia

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“…emphasized that ED and pain are two distinct entities, which cannot be readily discriminated using PAED and FLACC scores. 25 Regardless, the ability to clinically isolate ED from pain is of importance, with the possibility of improving treatment of ED in the future. Another limitation of our study is the measurement of PAED scores at 15-minute intervals.…”

Section: Discussionmentioning

confidence: 99%

Comparing incidence of emergence delirium between sevoflurane and desflurane in children following routine otolaryngology procedures

et al. 2017

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“…The incidence of emergence delirium in children occurs in the order of 15% of patients, but incidences as high as 50% have been reported. [1][2][3][4] It is important to identify risk factors for emergence delirium, so that clinicians may prophylactically treat high-risk patients. The association between agitation at induction and emergence delirium has not been clearly delineated with contradictory results being reported.…”

Section: Introductionmentioning

confidence: 99%

Induction behaviour and race and its association with postoperative agitation in paediatric elective surgery

Swart

Rajah

Rodseth

2017

Southern African Journal of Anaesthesia and Analgesia

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Background: It has been suggested that preoperative agitation in children may be a risk factor for postoperative delirium and postoperative vomiting. Previous studies have suggested that adult African patients have a lower incidence of postoperative nausea and vomiting, but no such association has been shown in children. Aim: To determine the incidence of both postoperative delirium and postoperative vomiting in elective paediatric surgical patients in a South African hospital and their association with preoperative agitation and patient race. Methods: A retrospective database analysis was undertaken of patients 1-12 years of age undergoing elective surgery. The Watcha behavioural scale was used to assess pre-and postoperative agitation. A Watcha score > 2 defined significant preoperative agitation or postoperative delirium. Multivariable logistic regression evaluated ENT surgery, sex, age, volatile type, significant preoperative agitation and race as predictors of postoperative delirium. Sex, race, significant preoperative agitation, ENT surgery and vomiting prophylaxis were evaluated as predictors of postoperative vomiting. Results: Significant preoperative agitation occurred in 13.5% (125/928); postoperative delirium in 3.4% (32/928) and postoperative vomiting in 1.4% (12/856) of patients. Postoperative delirium occurred in 3.1% of African patients as compared with 10.4% of non-African patients (p = 0.007); and postoperative vomiting in 1.2% of African patients as compared with 4.4% of non-African patients (p = 0.074). The predictors of postoperative delirium were non-African race (odds ratio [OR] 3.67; 95% confidence interval [CI] 1.22-11.07; p = 0.021), significant preoperative agitation (OR 3.54; 95% CI 1.55-8.09; p = 0.003), and ENT surgery (OR 2.5; 95% CI 1.0-6.0; p = 0.040). Only non-African race predicted postoperative vomiting (OR 3.73; 95% CI 1.01-13.79; p = 0.049), which included other variables like ENT surgery, significant preoperative anxiety, PONV prophylaxis. Conclusion: Preoperative agitation, non-African race and ENT surgery were predictors of postoperative agitation. Postoperative vomiting was predicted only by non-African race, which correlates with the trend seen in adults, even though incidence difference between African and non-African patients was not statistically significant.

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Emergence delirium, pain or both? a challenge for clinicians

Cited by 52 publications

References 19 publications

A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Comparing incidence of emergence delirium between sevoflurane and desflurane in children following routine otolaryngology procedures

Induction behaviour and race and its association with postoperative agitation in paediatric elective surgery

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