Incidence and associated factors of emergence agitation after general anesthesia and surgery among pediatric patients: A prospective follow-up study

Abstract

IntroductionEmergence agitation is one of the significant anesthetic and surgery-related complications. It is usually short-lived but causes self-injury during agitation and it led to parental anxiety. This study was aimed to assess incidence and factors associated with emergence agitation after general anesthesia and surgery among pediatric patients at University of Gondar specialized hospital. MethodsA prospective follow-up study conducted on 153 pediatric patients aged 2–9 years who were operated from first February to April 30, 2019. Emergence agitation was recorded by the pediatrics anesthesia emergence delirium scale. Descriptive statistics performed to determine the incidence. To identify the associated factors multi-variable binary logistic regression was held, and a p-value <0.05 was considered as significant. ResultsEmergence agitation was experienced on eighty (52.3%) children with a mean and standard deviation of 12 ± 5.9 min of duration. Among agitated children, 8 (10%) of them developed adverse events related to agitation. Difficult parental separation behaviour (AOR = 2.688, 95% CI = 1.131–6.39), children aged 2–5 years (AOR = 2.688, 95% CI = 1.131–6.3925), isoflurane maintenance (AOR = 4.001, 95% CI = 1.733–9.234) and propofol administration after maintenance closure (AOR = 0.145, 95% CI = 0.030–0.695) were significantly associated with agitation. ConclusionBeing a preschool child, difficult parental separation and isoflurane maintenance were associated with emergence agitation. But propofol administration after maintenance closure was found to be protective. So, agitation should be assessed and detected in the postoperative period and efforts should apply to prevent emergence agitation.