The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica

Gooden, Rachel; Tennant, I; James, Brian; Augier, R; Crawford-Sykes, A; Ehikhametalor, Kelvin; Gordon‐Strachan, Georgiana; Harding-Goldson, Hyacinth

doi:10.1016/j.bjane.2013.09.012

Cited by 21 publications

(21 citation statements)

References 17 publications

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“…In the current study, we found that a slight reduction in heart rates was induced by DEX and low dosage of DEX administration may contribute to the discrepancy, compared with the previous study. It has been demonstrated that intense preoperative anxiety in children can increases incidence of restless recovery from anesthesia [30]. The limitation of present study is that we cannot rule out the influence of resistance of mask induction on emergence agitation.…”

Section: Discussionmentioning

confidence: 77%

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Lin

Chen

Huang

et al. 2016

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 77%

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Lin

Chen

Huang

et al. 2016

Journal of Clinical Anesthesia

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“…14 Effective pain treatment is therefore very important in children undergoing tonsillectomy, because it may reduce the risk of postoperative bleeding due to emergence agitation, 15 and hemorrhage may be a potentially life-threatening complication. 16 Reports in the literature are lacking regarding the use of preemptive parecoxib sodium in children undergoing tonsillectomy.…”

Section: Discussionmentioning

confidence: 99%

Parecoxib sodium reduces the need for opioids after tonsillectomy in children: a double-blind placebo-controlled randomized clinical trial

Zhou

Xia

et al. 2015

Can J Anesth/J Can Anesth

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Parecoxib sodium reduces the need for opioids after tonsillectomy in children: a double-blind placebo-controlled randomized clinical trial Le parécoxib sodique réduit le besoin d'opioïdes après une amygdalectomie chez l'enfant: une étude clinique randomisée contrôlée par placebo à double insu AbstractObjective Postoperative pain is a common phenomenon after pediatric tonsillectomy. This prospective randomized double-blind placebo-controlled clinical trial was performed to evaluate the analgesic efficacy of intravenous parecoxib sodium in children undergoing tonsillectomy. Methods Sixty children (American Society of Anesthesiologists physical status I-III, aged three to seven years, and scheduled to undergo elective tonsillectomy under general anesthesia) were randomly allocated into one of two groups to receive intravenous parecoxib sodium 1 mgÁkg -1 (Group P, n = 30) or the same volume of saline (Group S, n = 30) just after induction of general anesthesia. Between-group comparisons were made for the number of patients requiring rescue morphine, total number of doses of postoperative rescue morphine, time to first rescue analgesic, postoperative pain and sedation scores, and adverse effects. Results Rescue morphine was given to more children in Group S (25/30, 83%) than in Group P (17/30, 57%) [relative risk (RR), 1.5; 95% confidence interval (CI), 1.0 to 2.1; P = 0.024]. The mean (SD) time to first rescue analgesic was shorter in Group S than in Group P [132 (54) min vs 193 (78) min, respectively; mean difference, 61; 95% CI, 26.6 to 96.1; P = 0.001]. The median (interquartile range [IQR]) Children's Hospital of Eastern Ontario Pain Scale scores in the postanesthesia care unit were lower in Group P than in Group S (7 [5-8] vs 9 [8-11], respectively; P = 0.001). The incidence of postoperative nausea and vomiting (PONV) was higher in Group S than in Group P [11/30 (37%) vs 4/30 (13%), respectively; RR, 2.8; 95% CI, 1.0 to 7.7; P = 0.037]. Conclusions A single intravenous injection of parecoxib sodium 1 mgÁkg -1 after anesthesia induction is an effective method for the control of postoperative pain. It provides a morphine-sparing effect, prolongs the time to first rescue analgesic, and reduces PONV in children undergoing tonsillectomy. RésuméObjectif La douleur postopératoire est un phénomène courant après une amygdalectomie pédiatrique. Cette étude clinique prospective randomisée contrô lée par placebo et à double insu a été réalisée afin d'évaluer l'efficacité analgésique du parécoxib sodique intraveineux chez des enfants subissant une amygdalectomie. Méthode Soixante enfants (statut physique I-III selon la classification de l'American Society of Anesthesiologists, âgés de trois à sept ans et devant subir une amygdalectomie non urgente sous anesthésie générale) ont été aléatoirement alloués à l'un de deux groupes. Le groupe P (n = 30) a reçu 1 mgÁkg -1 de parécoxib sodique intraveineux, alors que le groupe S (n = 30) a reçu le même volume de sérum physiologique juste après l'induction de l'anesthésie générale. ...

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“…Anxiety, as measured by the mYPAS, occurred in 69.2% of the children. It was measured at the time of mask induction when it is known to peak 22 and other studies have found a similar incidence 13,23 . ED was associated with the absence of apparent anxiety at induction (as evaluated with mYPAS), and a negative correlation was found between the two scores.…”

Section: Discussionmentioning

confidence: 79%

Emergence delirium in children undergoing dental surgery under general anesthesia

Jooma

Perrie

Scribante

et al. 2020

Pediatric Anesthesia

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Background: Emergence delirium is a well-described complication in pediatric anesthesia, occurring more often following short surgical procedures using volatile anesthetics with a rapid recovery profile. Dental extractions and conservation dentistry are commonly performed in children and are not painful postoperatively. The use of nerve blocks and local anesthetic infiltration intraoperatively limits nociception and obviates the need for opioids, allowing for more objective assessment of emergence delirium. Aim: The purpose of this preliminary study was to describe the incidence of emergence delirium and the associated risk factors in children undergoing elective dental surgery under general anesthesia at a regional academic hospital in South Africa. Methods: A prospective, descriptive study of healthy children aged 2-6 years was undertaken. Patients were anesthetized using standardized protocols. Assessments included demographics of the child and caregiver, child anxiety at induction using the modified Yale Preoperative Anxiety Scale, intraoperative events, and Paediatric Anaesthesia Emergence Delirium score in the recovery room. Data were assessed for associations and correlations. Results: Ninety-one children with a mean age of 3.9 (SD = 0.9) years were included. Anxiety was present in 69.2% at induction and emergence delirium occurred in 51.6% of the patients. The mean (SD, range) Paediatric Anaesthesia Emergence Delirium score in the patients without emergence delirium was 7 (2.65, 0-9) and in patients with emergence delirium was 14 (2.52, 10-18). Children with emergence delirium required more interventions in the recovery room but few required pharmacological treatment. Conclusions: Emergence delirium occurs commonly after dental surgery, and the majority of the children presenting for dental surgery are anxious at induction. Children with emergence delirium require more interventions in the recovery room but few require pharmacological treatment.

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The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica

Cited by 21 publications

References 17 publications

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

Parecoxib sodium reduces the need for opioids after tonsillectomy in children: a double-blind placebo-controlled randomized clinical trial

Emergence delirium in children undergoing dental surgery under general anesthesia

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