Assessing behaviour in children emerging from anaesthesia: can we apply psychiatric diagnostic techniques?

Przybylo, H. J.; Martini, Daniela; Mazurek, Aleksandra; Bracey, E; Johnsen, Lars Gunnar; Coté, Charles J.

doi:10.1046/j.1460-9592.2003.01099.x

Cited by 66 publications

(55 citation statements)

References 34 publications

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“…Outros estudos confirmaram estes resultados e, desde então, o grupo mais estudado situa-se na faixa etária de 2 a 4 anos de idade [7][8][9] . A explicação para incidência maior neste grupo parece ser a labilidade emocional exacerbada diante de uma situação de estresse em um ambiente estranho, além de condições fisiológicas do hipocampo ainda imaturo nessa faixa etária 10 .…”

Section: Idadeunclassified

Emergence agitation in pediatric anesthesia: current features

Silva¹,

Braz²,

Módolo³

2008

J Pediatr (Rio J)

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ResumoObjetivo: A agitação pós-operatória é um fenômeno clínico bem documentado em crianças, com incidência variando de 10 a 67%. Não existe explicação definitiva para a agitação no despertar. Várias causas têm sido discutidas na literatura, como rápido retorno à consciência em ambiente não familiar, presença de dor (ferida, dor de garganta, distensão vesical, etc.), estresse na indução, hipoxemia, obstrução da via aérea, ambiente barulhento, duração da anestesia, temperamento da criança, uso de medicação pré-anestésica e técnica anestésica empregada. O objetivo deste estudo é discutir as possíveis causas da agitação pós-operatória em crianças, subsidiando ações referentes à identificação e prevenção mais adequada. Fontes dos dados:Artigos originais e revisões, publicados no período de 1991 a 2007 e indexados no MEDLINE e PubMed, utilizando as seguintes palavras-chave: agitação no despertar, incidência, etiologia, diagnóstico, tratamento, criança, anestesia pediátrica.Síntese dos dados: É apresentada neste artigo uma revisão de possíveis desencadeadores de agitação, assim como uma proposta de escala para uniformização adequada do diagnóstico e medidas que implementam a prevenção e o tratamento. Conclusões:Nenhum fator pode, de maneira isolada, ser implicado como causador de agitação pós-operatória, devendo ser considerada como uma síndrome com componentes biológicos, farmacológicos, psicológicos e sociais, os quais o anestesiologista e o pediatra intensivista devem estar preparados para identificar, prevenir e intervir adequadamente quando necessário. J Pediatr (Rio J). 2008;84(2):107-113:Agitação no despertar, incidência, etiologia, tratamento, anestesia pediátrica, crianças. AbstractObjective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation.Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia. Summary of the findings:This study includes a review of potential agitation trigger factors and a proposal for a standardized

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Section: Idadeunclassified

Emergence agitation in pediatric anesthesia: current features

Silva¹,

Braz²,

Módolo³

2008

J Pediatr (Rio J)

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“…Other studies have confirmed these results and, since then, the group that has received most research attention is that from 2 to 4 years of age. [7][8][9] The cause of the increased incidence in this group appears to be that their emotional lability is exacerbated when faced with a stressful situation in an unfamiliar environment, in addition to the physiological condition of the hippocampus, which is still immature at this age. 10 …”

Section: Agementioning

confidence: 99%

“…However, in that study, a standardized agitation scale was not used, being based on an observational analysis of the event, and the sample size was small. 9 Risk factors for the occurrence of agitation had been assessed and no association was detected with the presence or absence of parents in the anesthetic recovery room. Agitation appears to primarily reflect a partially conscious process, in which the presence of parents does not have any significant impact on the behavior of the child.…”

Section: Psychological Social and Environmental Factors Related To Tmentioning

confidence: 99%

Agitação no despertar da anestesia em crianças: aspectos atuais

Silva¹,

Braz²,

Módolo³

2008

J. Pediatr. (Rio J.)

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Objective: Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.Sources: MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia. Summary of the findings:This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment. Conclusion:No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.

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“…These efforts have used the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for guidance in the development of evaluation tools. 2,3 Delirium is defined as a "temporary mental disturbance" that is marked by "agitation, hallucinations, and incoherence." 4 Sikich and Lerman 2 defined emergence delirium as "a disturbance in a child's awareness of and attention to his or her environment with disorientation and perceptual alterations including hypersensitivity to stimuli and hyperactive motor behavior in the immediate postanesthesia period."…”

mentioning

confidence: 99%

“…For example, children may exhibit behavioral changes related to an unfamiliar environment. 3 Agitation is a mild state of restlessness and mental distress. 5 Emergence delirium has the potential to be confused with emergence agitation, but it may be a cause of agitation.…”

mentioning

confidence: 99%