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[Risk factors associated with anesthesia emergence delirium in children undergoing outpatient surgery]
Ana Carolina Tavares Paes Barreto1, Ana Carolina Rangel da Rocha Paschoal2, Carolina Barbosa Farias3
1Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Serviço de Anestesiologia, Recife, PE, Brasil.
Insights
Postoperative pain significantly increases the risk of anesthesia emergence delirium in children undergoing outpatient surgery. This study found a 27% prevalence of delirium, with pain being a key contributing factor.
Area of Science:
- Pediatric Anesthesiology
- Clinical Research
Background:
- Anesthesia emergence delirium (AED) is a common, self-limiting condition in children post-surgery.
- Potential contributing factors include environmental disturbances, anesthetic agents, and preoperative anxiety.
Purpose of the Study:
- To investigate the prevalence of AED in children undergoing outpatient surgery.
- To identify risk factors associated with AED in this pediatric population.
Main Methods:
- A prospective observational study involving 100 children aged 2-10 years undergoing outpatient surgery.
- Risk factors analyzed included preoperative anxiety, impulsive behavior, pre-anesthetic medication, induction type, and postoperative pain.
- Multivariate Poisson's logistic regression was employed to determine associations.
Main Results:
- The prevalence of anesthesia emergence delirium was 27%, with 20% experiencing postoperative pain.
- Postoperative pain was significantly associated with AED, showing a prevalence ratio of 3.91 (p<0.000).
Conclusions:
- Anesthesia emergence delirium affects 27% of children in outpatient settings.
- Postoperative pain is a significant risk factor, increasing the incidence of AED in children.
Introduction:
Anesthesia emergence delirium is a self-limiting clinical phenomenon very common in children. Although pathophysiology is still uncertain, some factors seem to be involved, such as rapid awakening in an unknown environment, agitation during anesthetic induction, preoperative anxiety, environmental disorders, use of preanesthetic medication, use of inhalational anesthetics, and postoperative pain.
Objective:
To determine the prevalence and risk factors associated with anesthesia emergence delirium in children undergoing outpatient surgery.
Methods:
A prospective observational study was carried out with 100 children aged 2 to 10 years, who underwent surgery on an outpatient basis. The study variables were: anesthesia emergence delirium and the associated risk factors (preoperative anxiety, child impulsive behavior, use of pre-anesthetic medication, traumatic induction, type of anesthesia, and postoperative pain). Multivariate Poisson's logistic regression was used to analyze the possible explanatory variables, where the prevalence ratios were estimated with the respective 95% confidence intervals, considering a significance level of 5%.
Results:
Delirium and pain were observed in 27% and 20% of children, respectively. Only postoperative pain after Poisson's regression, was shown to be associated with anesthesia emergence delirium, with a prevalence ratio of 3.91 (p<0.000).
Conclusion:
The present study showed 27% prevalence of anesthesia emergence delirium in the study population. The incidence of anesthesia emergence delirium was higher in children who had postoperative pain.
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