Emergence agitation in children: an update

Area of Science:

• Pediatric Anesthesiology
• Postanesthetic Care
• Child Psychology

Background:

• Emergence agitation is a common postanesthetic behavioral issue in children.
• Current assessment tools may have limitations in accuracy and specificity.

Purpose of the Study:

• To review recent advancements in assessing, understanding the causes of, and managing emergence agitation in pediatric patients.
• To highlight the need for improved assessment tools and identify risk factors.

Main Methods:

• Literature review of recent studies on emergence agitation in children.
• Analysis of assessment tools, etiological factors, and management strategies.
• Identification of high-risk pediatric patient populations.

Main Results:

• Newer assessment scales incorporating cognitive and behavioral items have been developed.
• Risk factors include preoperative anxiety, certain anesthetic agents, and a distressing emergence environment.
• Children undergoing head and neck surgery with anxious parents are particularly vulnerable.

Conclusions:

• Implementing targeted interventions for high-risk children is recommended.
• Strategies include reducing preoperative anxiety, using adjuvant medications with inhalational agents, and managing pain effectively.
• Parental presence during recovery can mitigate emergence agitation.