Incidence and risk factors of emergence delirium in elderly patients after general or spinal anesthesia for both elective and emergency surgery

Assefa, Muleta Teshome; Chekol, Wubie Birlie; Melesse, Debas Yaregal; Nigatu, Yonas Addisu; Bizuneh, Yosef Belay

doi:10.1016/j.amsu.2022.104959

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Avoidable factors that contribute to the emergence of delirium include anxiety, past smoking history, substance abuse, preoperative anemia, surgical history, hypertension, metochloropromide, and thiopentone were found to be independently linked to a higher risk of emergence of delirium. This nding is supported with previously published articles (11,20,24,28).…”

Section: Discussionsupporting

confidence: 90%

“…Few researchers have evaluated the prevalence of inadequate emergence, which ranges from 3 to 6%, in older adults (5,16,(20)(21)(22)(23). There hasn't been any research done on the frequency of hypoactive emergence in the same patient population, however, it occurs 3.2% of the time in adult surgical patients (5,23), It is less than what we discovered.…”

Section: Discussionmentioning

confidence: 99%

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Elective elderly patients undergoing thoracoabdominal surgery in the post- anesthesia care unit are at risk for inadequate emergence, (hypoactive emergence and emergence with delirium). A Cross-Sectional study

Bayable,

Debas,

Alle

et al. 2024

Preprint

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Background:- This study aimed to ascertain the prevalence and contributing variables of unsatisfactory emergence after general anesthetic service for elderly patients undergoing thoracoabdominal operations. Method: - In 2022, a cross-sectional study was carried out between December and June. All consenting patients participate with written informed consent after receiving ethical approval. Data has been collected through personally conducting interviews and chart reviews during the pre- and post-operative periods. The descriptive statistics were determined using cross-tabulation or frequency and percentage. Bi-variable and multivariable logistic regression models were fitted to identify predictive variables that were linked to the outcome variable. For multivariable regression, P-values of 0.05 were used to assess statistical significance. RESULTS; - According to the current study, 90.5% (87.4-93.3) of surgical patients under general anesthesia experienced a normal emergence; in contrast, 5.70 %( 3.6-8.2) and 3.90 %( 2.1-5.9) of instances experienced an emergence with delirium and hypoactivity, respectively. A greater risk for emerging delirium was independently linked to anxiety, smoking, substance misuse, anemia, surgical history within three months, hypertension, metoclopramide prophylaxis, thiopentone, and pain ≥4 upon PACU admission,whereas male sex and patients who had ketofol induction were linked to a decreased chance of inadequate emergence. In elderly patients undergoing elective thoracoabdominal surgery, hypothermia in PACU, ASA III, exercise tolerance test (MET<4), and halothane, were found to be independently linked to hypoactive emergence, whereas pethidine, fluid intake ≥2000 ml, blood loss ≥500 ml, surgical duration >2 hrs, and PONV requiring antiemetic were significant risk factors for inadequate emergence. CONCLUSION: - Despite the fact that risk factors are preventable, inadequate emergence is a common complication in elderly thoraco-abdominal surgery that presents challenges for anesthetists and PACU staff. Among elderly patients having thoraco-abdominal surgery, hypoactive emergence was less frequent than emergence delirium.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Elective elderly patients undergoing thoracoabdominal surgery in the post- anesthesia care unit are at risk for inadequate emergence, (hypoactive emergence and emergence with delirium). A Cross-Sectional study

Bayable,

Debas,

Alle

et al. 2024

Preprint

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“…General anesthesia is commonly used for radical NSCLC surgery and can assist in the smooth implementation of surgery. However, there have been reports indicating the occurrence of emergence agitation (EA) after general anesthesia[ 4 ]. EA is an adverse reaction to general anesthesia, characterized by a state of consciousness and behavioral dissociation during the recovery period, manifested as excitement, agitation, disorientation, and inappropriate behavior.…”

Section: Introductionmentioning

confidence: 99%

Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients

Yan,

Yuan,

et al. 2024

World J Psychiatry

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BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery. Emergence agitation (EA) is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications. Pre-anesthetic anxiety may be associated with the development of EA, but studies in this area are lacking. AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer (NSCLC). METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled. We used the Hospital Anxiety and Depression Scale’s (HADS) anxiety subscale (HADS-A) to determine patients’ anxiety at four time points (T1-T4): patients’ preoperative visit, waiting period in the surgical waiting room, after entering the operating room, and before anesthesia induction, respectively. The Riker Sedation-Agitation Scale (RSAS) examined EA after surgery. Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’ pre-anesthesia anxiety status and EA. We performed a partial correlation analysis of HADS-A scores with RSAS scores. RESULTS NSCLC patients’ HADS-A scores gradually increased at the four time points: 7.33 ± 2.03 at T1, 7.99 ± 2.22 at T2, 8.05 ± 2.81 at T3, and 8.36 ± 4.17 at T4. The patients’ postoperative RSAS score was 4.49 ± 1.18, and 27 patients scored ≥ 5, indicating that 33.75% patients had EA. HADS-A scores at T3 and T4 were significantly higher in patients with EA (9.67 ± 3.02 vs 7.23 ± 2.31, 12.56 ± 4.10 vs 6.23 ± 2.05, P < 0.001). Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4. Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4 (r = 0.296, 0.314, P < 0.01). CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.

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Predictive Application for Early Delirium Detection Subtypes Using GLM’s

Coelho,

Braga

2024

Computational Science and Its Applications – ICCSA 2024 Workshops

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Incidence and risk factors of emergence delirium in elderly patients after general or spinal anesthesia for both elective and emergency surgery

Cited by 3 publications

References 22 publications

Elective elderly patients undergoing thoracoabdominal surgery in the post- anesthesia care unit are at risk for inadequate emergence, (hypoactive emergence and emergence with delirium). A Cross-Sectional study

Elective elderly patients undergoing thoracoabdominal surgery in the post- anesthesia care unit are at risk for inadequate emergence, (hypoactive emergence and emergence with delirium). A Cross-Sectional study

Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients

Predictive Application for Early Delirium Detection Subtypes Using GLM’s

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