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Cause analysis, prevention, and treatment of postoperative restlessness after general anesthesia in children with
Hao Xu1, Xiao-Peng Mei2, Li-Xian Xu3
1Institution of Basic Medical Science, Xi'an Medical University, Xi'an, China.
Insights
Postoperative emergence agitation (EA) is common in children undergoing cleft palate surgery due to anesthesia and surgical factors. This review summarizes EA
Area of Science:
- Oral and Maxillofacial Surgery
- Pediatric Anesthesia
- Congenital Malformations
Background:
- Cleft palate is a common congenital oral malformation, affecting approximately 0.1% of newborns.
- Surgical repair is the primary treatment for cleft lip and palate.
- Children undergoing cleft palate surgery experience higher rates of postoperative emergence agitation (EA) compared to other surgical interventions.
Purpose of the Study:
- To review current literature on emergence agitation (EA) in pediatric cleft palate surgery.
- To identify induction factors contributing to EA in this patient population.
- To outline strategies for the prevention and management of EA.
Main Methods:
- Systematic literature review of recent studies on emergence agitation following general anesthesia in children.
- Analysis of factors influencing EA, including anesthetic agents and surgical specifics.
- Synthesis of evidence-based recommendations for clinical practice.
Main Results:
- Postoperative emergence agitation (EA) is frequently observed in children after cleft palate repair.
- The precise mechanisms of EA in this context remain incompletely understood.
- While typically self-limiting, EA can impact patient and clinician experience.
Conclusions:
- Emergence agitation (EA) is a significant concern in pediatric cleft palate surgery.
- Further research into EA mechanisms is warranted.
- Clinical guidelines for EA prevention and management are essential for optimizing postoperative care.
Abstract:
Cleft palate is one of the most common congenital malformations of the oral and maxillofacial region, with an incidence rate of around 0.1%. Early surgical repair is the only method for treatment of a cleft lip and palate. However, because of the use of inhalation anesthesia in children and the physiological characteristics of the cleft palate itself combined with the particularities of cleft palate surgery, the incidence rate of postoperative emergence agitation (EA) in cleft palate surgery is significantly higher than in other types of interventions. The exact mechanism of EA is still unclear. Although restlessness after general anesthesia in children with cleft palate is self-limiting, its effects should be considered by clinicians. In this paper, the related literature on restlessness after surgery involving general anesthesia in recent years is summarized. This paper focuses on induction factors as well as prevention and treatment of postoperative restlessness in children with cleft palate after general anesthesia. The corresponding countermeasures to guide clinical practice are also presented in this paper.
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