To identify the incidence and risk factors of emergence agitation following nasal surgery under general anesthesia: A prospective observational study

Abstract

Abstract Background and Aims: Emergence agitation (EA) is a common condition that occurs during early phase of general anesthesia (GA) recovery. Increased risk of EA is found among ear, nose, and throat procedures and it has been an independent risk factor. The aim of the study is to identify the incidence and risk factors of EA following nasal surgeries. Methods: This prospective observational study was performed on 68 patients aged 18–70 years of either sex and American Society of Anesthesiologists (ASA) physical status Grade I-III who underwent GA for elective nasal surgery. The data were collected including age, gender, ASA physical status, pain, duration of surgery, preoperative anxiety level, extubation time, smoking, associated comorbidity, and preoperative use of benzodiazepine. Postoperatively, patients were assessed for emergence delirium by Richmond Agitation Sedation Scale, complications, and pharmacological treatment for EA. The data were analyzed by Student’s t-test, Chi-square test, and binary logistic regression test. Results: The incidence of EA was found to be 27.5% (19 patients). EA was found to be significantly associated with preoperative Visual Anxiety Score (P = 0.001), postoperative pain (P = 0.046), male gender (P = 0.015), premedication with benzodiazepine (P = 0.022), ASA physical status (P = 0.0002), and hypertension (P = 0.022). Immediate postoperative complications such as cough, desaturation, laryngospasm, breath holding, and nasal bleeding were found to be statistically significant (P = 0.01) in patients with EA. Conclusion: EA is common after nasal surgery under GA and better understanding of potential risks and precipitating factors along with sufficient postoperative pain management may be useful to reduce EA occurrence and consequent postoperative complications.