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Emergence agitation in children: risk factors, prevention, and treatment

Akihiro Kanaya1

  • 1Department of Anesthesiology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. a-kanaya@med.tohoku.ac.jp.

Journal of Anesthesia
|November 26, 2015
PubMed

Insights

Emergence agitation (EA) in children is a common postoperative problem. Selecting anesthesia methods unlikely to cause EA and promptly treating it can improve patient safety and satisfaction.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Postoperative Care

Background:

  • Emergence agitation (EA) is a significant postoperative concern in children, leading to self-harm, increased nursing workload, and decreased parental satisfaction.
  • Identified risk factors for EA include patient age, preoperative anxiety, personality traits, pain levels, and specific anesthetic agents and surgical procedures.
  • While sevoflurane and desflurane are commonly used for their favorable pharmacokinetic properties, they are increasingly implicated as potential causes of EA in pediatric patients.

Purpose of the Study:

  • To review the causes, risk factors, and management strategies for emergence agitation in children.
  • To highlight anesthetic techniques and pharmacological interventions for preventing and treating EA.
  • To emphasize the importance of selecting appropriate anesthesia methods and timely treatment for EA in pediatric surgical patients.

Main Methods:

  • Review of existing literature on emergence agitation in pediatric anesthesia.
  • Analysis of risk factors associated with EA, including anesthetic agents and patient-specific variables.
  • Evaluation of pharmacological interventions for EA prevention and treatment.

Main Results:

  • Certain anesthetic agents like sevoflurane and desflurane may contribute to EA.
  • Perioperative administration of opioids, midazolam, ketamine, alpha-2 agonists, and NSAIDs has shown efficacy in preventing and treating EA.
  • Propofol-based anesthesia maintenance has also demonstrated effectiveness in reducing EA incidence.

Conclusions:

  • Anesthesia methods should be chosen carefully in children to minimize the risk of EA.
  • Prompt and appropriate pharmacological treatment is crucial for managing EA when it occurs.
  • Optimizing anesthetic management can significantly improve postoperative outcomes and patient/parent satisfaction.

Keywords:
Emergence agitationPropofolSevoflurane

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