Risk Factors for Emergence Agitation in the Postanesthesia Care Unit: A Propensity Score-Matched Analysis
Sun Hee Moon1, Seon Young Hwang2
1Recovery Room, Graduate School of Hanyang University, Samsung Medical Center in Seoul, Korea.
Summary
High pain scores, urology/gynecology procedures, and longer anesthesia predict emergence agitation (EA) after general anesthesia. Identifying these risk factors in the postanesthesia care unit (PACU) aids patient management.
Area of Science:
- Anesthesiology
- Postoperative Care
- Patient Safety
Background:
- Emergence agitation (EA) is a common complication following general anesthesia.
- Effective management strategies require understanding EA's predictors and risk factors.
Purpose of the Study:
- To identify predictors of acute emergence agitation (EA) in the postanesthesia care unit (PACU).
- To examine associated risk factors for EA following general anesthesia.
- To inform effective management strategies for EA.
Main Methods:
- Retrospective observational study involving secondary data analysis of 15,667 adult patients.
- Propensity score matching (1:4 ratio) was used, resulting in a final analysis of 6,620 patients.
- Risk factors for EA (defined as Richmond Agitation-Sedation Scale score ≥ +1) were analyzed using binary logistic regression.
Main Results:
- High pain scores (≥7), urology/gynecology procedures, lower serum albumin, and lower blood glucose levels were significant predictors of EA.
- Anesthesia duration >2 hours, presence of a urinary catheter, and first-time anesthesia also increased EA risk.
- Patients with pain scores ≥7 had an 8-fold higher odds of EA (OR=8.080).
Conclusions:
- Patients undergoing general anesthesia with identified risk factors are at high risk for EA.
- PACU nurses should proactively identify and manage high-risk patients.
- Understanding these predictors can improve postoperative care and patient outcomes.
