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Incidence of Emergence Delirium in the Pediatric PACU: Prospective Observational Trial

Authors :
Eva Klabusayová
Tereza Musilová
Dominik Fabián
Tamara Skříšovská
Václav Vafek
Martina Kosinová
Michaela Ťoukálková
Adéla Vrtková
Jozef Klučka
Petr Štourač
Source :
Children, Vol 9, Iss 10, p 1591 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, agitation, and are at higher risk of unintentional extraction of an intravenous cannula, self-harm and nausea and vomiting. The described incidence of ED varies between 25–80%, with a higher prevalence among children younger than 6 years of age. We aimed to determine the incidence of ED in pediatric patients (>1 month) after general anesthesia in the post-anesthesia care unit (PACU), using Paediatric Anaesthesia Emergence Delirium (PAED) score, Watcha score and Richmond agitation and sedation scale (RASS). The incidence of ED was the highest in the PAED score with cutoff ≥10 points (89.0%, n = 1088). When using PAED score >12 points, ED incidence was 19.3% (n = 236). The lowest incidence was described by Watcha and RASS scores, 18.8% (n = 230) vs. 18.1% (n = 221), respectively. The threshold for PAED ≥10 points seems to give false-positive results, whereas the threshold >12 points is more accurate. RASS scale, although intended primarily for estimation of the depth of sedation, seems to have a good predictive value for ED.

Details

Language :
English
ISSN :
22279067
Volume :
9
Issue :
10
Database :
Directory of Open Access Journals
Journal :
Children
Publication Type :
Academic Journal
Accession number :
edsdoj.296accccab04bffbefc174b35896e8e
Document Type :
article
Full Text :
https://doi.org/10.3390/children9101591