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Updated: Jun 24, 2025

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Discharge Under Sedated Status can Decrease Postoperative Emergence Agitation in Pediatric Patients Undergoing

Fang Tan1, Weisha Lu2, Shuangshuang Li1

  • 1Department of Anesthesiology, Anesthetist, Eye & ENT Hospital, Fudan University, China.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|June 6, 2024
PubMed
Summary

Discharging sedated pediatric patients from the postanesthesia care unit (PACU) to wards significantly reduced emergence agitation (EA). This strategy also decreased the need for rescue measures and shortened PACU discharge time.

Keywords:
emergence agitationpediatricpostanesthesiastrabismus surgery

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Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Postanesthesia Care

Background:

  • Emergence agitation (EA) is a common complication following anesthesia in pediatric patients.
  • Strabismus surgery in children is frequently associated with EA.
  • Current management strategies for EA are varied and their effectiveness is under investigation.

Purpose of the Study:

  • To investigate the efficacy of discharging pediatric patients from the postanesthesia care unit (PACU) to wards in a sedated state to reduce the incidence of EA.
  • To compare EA incidence between sedated and fully awake pediatric patients discharged from PACU.
  • To evaluate secondary outcomes including rescue measures, discharge time, hemodynamic parameters, and parental satisfaction.

Main Methods:

  • Prospective randomized controlled study involving 100 pediatric patients (4-6 years old) undergoing strabismus surgery.
  • Patients were randomized into two groups: a sedated group (Group P, n=50) discharged to the ward under sedation, and a control group (Group C, n=50) discharged fully awake.
  • Primary outcome was the incidence of EA; secondary outcomes included rescue measures, PACU discharge time, hemodynamic parameters, and parental satisfaction.

Main Results:

  • The incidence of EA was significantly lower in the sedated group (Group P) compared to the control group (Group C) (P=.023).
  • Fewer patients required rescue measures in Group P than in Group C (P=.041).
  • PACU discharge time was significantly shorter in Group P (P<.001), with lower heart rate at discharge (P=.003). Oxygen saturation and mean arterial blood pressure were comparable.

Conclusions:

  • Discharging pediatric patients undergoing strabismus surgery to their parents in a sedated state effectively reduces the incidence of emergence agitation.
  • This approach offers potential benefits in managing postoperative pediatric patients, including reduced need for interventions and faster PACU discharge.
  • Sedated discharge may be a valuable strategy for improving the postanesthesia recovery experience in pediatric surgical patients.