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Postoperative agitation or delirium in paediatric patients. What we know and how to avoid it
M López Segura1, N Busto-Aguirreurreta2
1Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Insights
Emergence delirium, a postoperative agitation affecting children, occurs in up to 80% of cases. Recognizing risk factors like preoperative anxiety is key to improving pediatric patient safety.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Background:
- Emergence delirium (ED), or postoperative agitation, is a state of altered consciousness post-surgery.
- It significantly impacts pediatric patients, with incidence rates reaching 80% in some studies.
- ED is often misdiagnosed, necessitating validated diagnostic tools.
Purpose of the Study:
- To highlight the significance of emergence delirium in pediatric patients.
- To identify key risk factors associated with ED.
- To emphasize the importance of recognizing and managing ED for patient safety.
Main Methods:
- Literature review on emergence delirium in pediatric populations.
- Analysis of validated diagnostic scales for ED.
- Identification of risk factors through existing studies.
Main Results:
- Pediatric emergence delirium is a common postoperative complication.
- Key risk factors include young age (under 5 years), postoperative pain, and high preoperative anxiety.
- Validated scales aid in distinguishing ED from other conditions.
Conclusions:
- Emergence delirium is a critical adverse event impacting pediatric patient safety.
- Early recognition of ED and its risk factors is essential for effective management.
- Implementing preventive strategies can reduce ED incidence and severity.
Abstract:
Emergence delirium or postoperative agitation is the name given to the state of altered consciousness that occurs after surgery and especially affects pediatric patients. Its incidence is not negligible, reaching 80% of cases in certain studies. It is frequently confused with other clinical entities, for which reason a scale has been validated to facilitate its diagnosis. Risk factors include age under 5 years, the presence of pain after surgery and especially intense preoperative anxiety. Pediatric emergence delirium presents as an adverse event after surgery and influences patient safety by significantly increasing patient comorbidity. It is essential to recognize the entity, as well as its risk factors, in order to apply effective preventive measures to reduce its incidence and intensity when it occurs.
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