Emergence delirium in children: up to date for pediatricians
Authors:
Frelich Michal 1,2; Burša Filip 1,2; Sklienka Peter 1,2; Trávníček Bořek 2,3; Nowaková Markéta 2,3; Pavlíček Jan 2,3,4
Authors place of work:
Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Ostrava
1; Lékařská fakulta, Ostravská univerzita, Ostrava
2; Klinika dětského lékařství, Fakultní nemocnice Ostrava
3; Centrum biomedicínského výzkumu, Fakultní nemocnice Hradec Králové
4
Published in the journal:
Čes-slov Pediat 2024; 79 (5): 266-270.
Category:
Pediatric Protocols in Praxis
doi:
https://doi.org/:10.55095/CSPediatrie2024/047
Summary
Emergence delirium (ED) is a common postoperative complication in children, characterized by desorientation, perception and psychomotor disorder. The described incidence of emergence delirium varies between 10-50 %. Although ED is self-limiting, it can induce postoperative complications, including self-injury, dehiscence of surgical wound, bleeding and other difficulties for medical staff. Despite extensive research of ED, precise pathophysiology remains uknown. PAED score is only validated tool for ED diagnosis. This review summarizes the risk factors of ED development and provide current options of pharmacologic and non-pharmacologic prevention and treatment.
Keywords:
General anesthesia – postoperative complications – emergence delirium
Zdroje
1. Mixa V, Klimovič M. Emergentní delirium po použití sevofluranu u dětí. Anest intenziv Med 2013; 24(6): 385–390.
2. Mason KP. Paediatric emergence delirium: a comprehensive review and interpretation of the literature. Br J Anaesth 2017; 118(3): 335–343.
3. Urits I, Peck J, Giacomazzi S, Patel R, et al. Emergence delirium in perioperative pediatric care: a review of current evidence and new directions. Adv Ther 2020; 37(5): 1897–1909.
4. Reduque L Verghese ST. Paediatric emergence delirium. Continuing Education in Anaesthesia, Critical Care & Pain 2013; 13(2): 39–41.
5. Vlajkovic GP, Sindjelic RP. Emergence delirium in children: many questions, few answers. Anesth Analg 2007; 104(1): 84–91.
6. Lee SJ, Sung TY. Emergence agitation: current knowledge and unresolved questions. Korean J Anesthesiol 2020;73 (6): 471–485.
7. Bonhomme V, Boveroux P, Brichant JF, et al. Neural correlates of consciousness during general anesthesia using functional magnetic resonance imaging (fMRI). Arch Ital Biol 2012; 150: 155–63.
8. Oh AY, Seo KS, Kim SD, et al. Delayed emergence process does not result in a lower incidence of emergence agitation after sevoflurane anesthesia in children. Acta Anaesthesiol Scand 2005; 49(3): 297–9.
9. Gibert S, Sabourdin N, Louvet N, et al. Epileptogenic effect of sevoflurane: determination of the minimal alveolar concentration of sevoflurane associated with major epileptoid signs in children. Anesthesiology 2012; 117(6): 1253–61.
10. Klabusayová E, Musilová T, Fabián D, et al. Incidence of emergence delirium in the pediatric PACU: prospective observational trial. Children (Basel) 2022; 21; 9(10): 1591.
11. Somaini M, Engelhardt T, Fumagalli R, Ingelmo PM. Emergence delirium or pain after anaesthesia--how to distinguish between the two in young children: a retrospective analysis of observational studies. Br J Anaesth 2016; 116(3): 377–83.
12. Nair S, Wolf A. Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment. BJA Educ 2018; 18(1): 30–33.
13. Byun S, Song S, Kim JH, et al. Mother‘s recorded voice on emergence can decrease postoperative emergence delirium from general anaesthesia in paediatric patients: a prospective randomised controlled trial. Br J Anaesth 2018; 121(2): 483–489.
14. Lin Y, Shen W, Liu Y, et al. Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled trial. Br J Anaesth 2018; 121(2): 476–482.
15. Frelich M, Lečbychová K, Vodička V, et al. Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial. Anaesth Crit Care Pain Med 2023; 43(1): 101318.
16. Doerrfuss JI, Kramer S, Tafelski S, et al. Frequency, predictive factors and therapy of emergence delirium: data from a large observational clinical trial in a broad spectrum of postoperative pediatric patients. Minerva Anestesiol 2019; 85(6): 617–624.
17. Kanaya A, Kuratani N, Satoh D, Kurosawa S. Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: a meta-analysis of randomized controlled trials. J Anesth 2014; 28(1): 4–11.
18. Heikal S, Stuart G. Anxiolytic premedication for children. BJA Eeducation 2020; 20: 220.
19. He J, Zhang L, Tao T, et al. Nalbuphine reduces the incidence of emergence agitation in children undergoing Adenotonsillectomy: A prospective, randomized, double-blind, multicenter study. J Clin Anesth 2023; 85: 111044.
20. Han X, Sun X, Liu X, Wang Q. Single bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia. Paediatr Anaesth 2022; 32(3): 446–451.
21. Lee-Archer PF, von Ungern-Sternberg BS, Reade MC, et al. An observational study of hypoactive delirium in the post-anesthesia recovery unit of a pediatric hospital. Paediatr Anaesth 2021; 31(4): 429–435.
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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