Evaluation of Factors Affecting Emergence Agitation in Pediatric Anesthesia Practice

Abstract

INTRODUCTION[|]The agitation that is sometimes seen in children during the recovery period after the administration of anesthesia can be a difficult problem to solve, and can turn a successful procedure into a distressing situation. This prospective, observational study was intended to determine factors that may lead to postoperative agitation in children in order to contribute to future pediatric anesthesia studies.[¤]METHODS[|]A total of 206 patients between 3 and 10 years of age who underwent operations performed by the departments of orthopedics and traumatology; urology; eye diseases; ear, nose, and throat diseases; pediatric surgery; and plastic and reconstructive surgery and whose physical status was classified as American Society of Anaesthesiologists I or II were included in the study. The patients' age, gender, details of preoperative fasting, previous surgeries (if any), premedication used (if any) and the method of application, the induction technique and drug used for anesthesia, airway management method, drugs used to maintain anesthesia and duration, postoperative analgesic management, and the duration of stay in the recovery room were recorded. In addition, the Face, Legs, Activity, Cry, Consolability score; the Pediatric Anesthesia Emergence Delirium score; and the modified Aldrete score recorded at the postoperative 10th minute were analyzed.[¤]RESULTS[|]Statistical evaluation revealed that age, operation type, anesthesia technique and drug selected, airway management method, drug used for induction and maintenance of anesthesia, and the duration of anesthesia significantly affected postoperative agitation (p<0.05). Regression analysis determined that patient age and the drug selected for the induction and the maintenance of anesthesia were independent risk factors for agitation developing during the recovery period.[¤]DISCUSSION AND CONCLUSION[|]The age of the child, the duration of anesthesia, and the preferred anesthesia induction technique were the primary factors affecting agitation seen in children during recovery from anesthesia. Since the age of the patient and the duration of the surgery and anesthesia are factors that it is difficult or impossible to change, the anesthesia induction technique to be used is an important tool for the anesthesiologist to control the development of agitation during the recovery period.[¤]

Keywords

• anesthesia
• emergence agitation; pediatric.