What is Emergence Delirium?
Emergence delirium (ED) is a condition characterized by a transient state of confusion, agitation, and disorientation that occurs as a child emerges from general anesthesia. It is often observed in the immediate postoperative period and can be distressing for both the child and the caregivers.
Agitation and restlessness
Crying or moaning without obvious cause
Thrashing or attempting to remove medical devices
Disorientation and confusion
Incoherent speech or inability to communicate effectively
Fear or panic
The type of anesthesia used, particularly
sevoflurane and
desflurane Age, with younger children (especially those aged 2-5) being more susceptible
Preoperative anxiety or a history of behavioral issues
Pain or discomfort
Environmental factors such as noise and unfamiliar surroundings
How Common is Emergence Delirium?
Emergence delirium is relatively common in pediatric patients, with incidence rates reported to be between 10% and 80%, depending on the criteria used for diagnosis and the population studied. The variability in incidence underscores the importance of recognizing and managing this condition effectively.
Pharmacologic: Medications such as
midazolam,
dexmedetomidine, and
propofol may be used to reduce agitation and improve recovery.
Non-Pharmacologic: Providing a calm and quiet environment, parental presence, comforting the child, and minimizing sensory overload can be beneficial.
Preoperative preparation and education to reduce anxiety
Using anesthesia techniques and medications associated with lower incidence of ED
Providing adequate pain control postoperatively
Ensuring a smooth and gentle emergence from anesthesia
What is the Prognosis for Children with Emergence Delirium?
Emergence delirium is typically a self-limiting condition, and most children recover fully without long-term consequences. However, it can be a traumatic experience for the child and family, highlighting the importance of effective management and support.
Reducing distress and discomfort for the child
Improving the overall experience of surgery and anesthesia
Preventing potential complications such as self-injury or interference with medical devices
Alleviating anxiety and stress for caregivers and healthcare providers
