Emergence delirium in children

Wong, Dina; Bailey, Craig R.

doi:10.1111/anae.13043

Cited by 40 publications

(40 citation statements)

References 46 publications

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“…The two most common anesthesia drugs used in our survey, sevoflurane and propofol, have many advantages over other drugs but are not without their problems. Many children suffer from emergence delirium (19) and injection pain (20) and our data show where large projects can be undertaken to test interventions or new drugs.…”

Section: Discussionmentioning

confidence: 76%

The state of UK pediatric anesthesia: a survey of National Health Service activity

Sury

Arumainathan

Belhaj

et al. 2015

Pediatric Anesthesia

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This secondary analysis of the 2013 United Kingdom National Health Service (NHS) Anaesthesia Activity Survey of the Fifth National Audit Project (of the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland) shows pediatric anesthesia activity in detail. A local coordinator (LC) in every NHS hospital collected data on patients undergoing any procedure managed by an anesthetist. Questionnaires had 30 question categories. Each LC was randomized to a 2-day period. The pediatric age groups were infants, (<1 year), preschool age (1-5 year), and school age children (6-15 year). The median questionnaire return rate was 98%. The annual caseload was estimated to be 486 900 children: 36 500 infants, 184 700 preschool age, and 265 800 school age children. Almost 90% of children (1-15 year) were ASA 1 or 2 and the substantial majority underwent routine nonurgent ear nose and throat, dental, orthopaedics, or general surgery procedures; 65% were 'day cases'. One in six children were managed outside operating theater sites compared with one in 12 adults. Forty one per cent was in district general hospitals. Almost all ASA 4 and 5 children (89%) and infants (92%) were managed in specialist hospitals. 'Awake' cases and sedation accounted for only 2% of cases. There were notable differences in demography and anesthetic care compared with adults and between different age groups of children. These data enable analysis of the current state of UK pediatric anesthetic practice and highlight differences between pediatric and adult services.

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Section: Discussionmentioning

confidence: 76%

The state of UK pediatric anesthesia: a survey of National Health Service activity

Sury

Arumainathan

Belhaj

et al. 2015

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Many ED risk factors, such as the child's age, ethnicity, socioeconomic background, temperament, previous hospital experience, anxiety level, and the length and type of procedure, have been reported in previous studies [14789]. However, the findings of those studies contradicted the results of others [49]. Our patient had very few ED risk factors; he had not undergone any painful ear, eye, or dental procedures and he did not have a previous history of ED or preoperative anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…After that, we used propofol 20 mg intravenously. Many articles have recommended intravenous boluses of sedative agents, such as midazolam 0.025–0.1 mg/kg or propofol 0.5–1.0 mg/kg, as a pharmacological 'rescue' treatment for ED [49]. While we chose propofol, dexmedetomidine (0.3 mg/kg) has been recommended as a preventive treatment against ED and has been found to be more effective than propofol in recent research [11].…”

Section: Discussionmentioning

confidence: 99%

Risperidone in a child with untractable emergency delirium: a case report

Shin

Lee

Kim

2016

Korean J Anesthesiol

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A 6-year-old boy was scheduled for thoracic magnetic resonance imaging under deep sedation with midazolam 1.8 mg and propofol 100 µg/kg/min via intravenous injection. He showed emergence delirium in the post-anesthesia care unit. The staff attempted to calm him by administering flumazenil as an antidote for midazolam, propofol for further sedation, and meperidine. However, this was not successful. A psychiatrist recommended the use of antipsychotics. Administration of risperidone led to immediate resolution of the boy's symptoms and relaxed him. The use of antipsychotic drugs is not common for anesthesiologists, but should be considered for treating uncontrolled emergence delirium after anesthesia.

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“…Its advantages over midazolam include: it mimics normal sleep EEG activity; does not seem to cause central respiratory depression; and its elimination halflife is not prolonged in infants. It has been used intravenously in the intensive care setting for a number of years and has also proved useful when administered as a single dose for the prevention of emergence delirium in children [17,18].…”

Section: Choice Dose and Mode Of Administration Of Sedative Agentsmentioning

confidence: 99%

How clinical registries can make a difference in hip fracture care

Neuman

2016

Anaesthesia

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Emergence delirium in children

Cited by 40 publications

References 46 publications

The state of UK pediatric anesthesia: a survey of National Health Service activity

The state of UK pediatric anesthesia: a survey of National Health Service activity

Risperidone in a child with untractable emergency delirium: a case report

How clinical registries can make a difference in hip fracture care

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