Evaluation of emergence agitation after general anaesthesia in rhinoplasty patients: Inhalation anaesthesia versus total intravenous anaesthesia

Talih, Gamze; Yüksek, Ahmet; Şahin, Ender

doi:10.1016/j.amjoto.2020.102387

Cited by 20 publications

(22 citation statements)

References 18 publications

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“…15 EA can lead to serious consequences such as various injuries, self-extubation, hemorrhage, increased pain, removal of catheters, respiratory depression, nausea/ vomiting, increased blood pressure/heart rate (HR), and myocardial oxygen consumption. 16 Pain management can be an effective preventive measure for EA. 17 In this study, we evaluated the hypothesis that preoperative bilateral ION and ITN blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of EA, pain scores, and the analgesic consumption after the septorhinoplasty.…”

Section: Introductionmentioning

confidence: 99%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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In this study, we evaluated the hypothesis that preoperative bilateral infraoptic nerve (ION) and infratrochlear nerve (ITN) blocks under general anesthesia with sevoflurane and remifentanil reduced the incidence of emergence agitation (EA), pain scores, and the analgesic consumption after the septorhinoplasty. Patients and Methods: Our study was conducted as a prospective randomized, double-sided blind study. Fifty-two patients whose septorhinoplasty operation was planned under general anesthesia were included in the study. Patients were randomly distributed to either the ION and ITN blocks were performed. Group 1: Bilateral ION and ITN blocks were performed; Group 2: ION and ITN blocks were not performed. Duration of the surgery and anesthesia, Riker Sedation-Agitation Scale (RSAS) score, EA presence, duration of postoperative analgesia, numerical rating scale (NRS) scores, and cumulative dexketoprofen consumption were recorded. Results: The RSAS score, NRS score and cumulative dexketoprofen consumption of the patients in Group 1 were statistically significantly lower than the patients in Group 2 (p<0.05). It was also found that patients in Group 1 (n: 8/26) had less EA compared to patients in Group 2 (n: 16/26) and this difference was statistically significant (p: 0.026). Postoperative analgesia duration of patients in Group 1 was found to be statistically significantly higher than patients in Group 2 (p: <0.001). In addition, the number of patients given postoperative dexketoprofen in Group 1 (n: 8/26) was found to be statistically significantly lower than patients in Group 2 (n: 25/26). (p: <0.001). Conclusion: Bilateral ION and ITN blocks in septorhinoplasty operation is an effective, reliable and simple technique in the treatment of postoperative pain.

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Section: Introductionmentioning

confidence: 99%

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Kaçar

Uzundere

Salık

et al. 2020

JPR

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“…Surgical anesthesia has certain risks, and perioperative factors can cause anxiety, fear, and other psychological changes in patients. Besides, the neglect of medical staff or family members will aggravate the symptoms of emergence agitation [ 22 ]. Hence, careful nursing during the perioperative period of anesthesia plays a crucial role in reducing anxiety and fear and improving the symptoms of complications during the recovery period.…”

Section: Discussionmentioning

confidence: 99%

Functional Magnetic Resonance Imaging of Brain Function and Emergence Agitation of Patients with Dexmedetomidine-Assisted General Anesthesia under Comfortable Nursing Intervention

Gao

Zheng

Liu

et al. 2022

Computational Intelligence and Neuroscience

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In order to explore the effects of dexmedetomidine (DEX) on functional magnetic resonance imaging (fMRI) and emergence agitation of patients who underwent general anesthesia surgery with sevoflurane under comfortable nursing intervention, 66 patients who received upper abdominal surgery were selected as research objects. According to nursing and anesthesia methods, the patients were randomly divided into control group (routine nursing and anesthesia), group A (routine nursing and DEX-assisted anesthesia), and group B (comfortable nursing and DEX-assisted anesthesia). The differences in the brain fMRI characteristics, hemodynamic indexes, anesthesia recovery indexes, and nursing satisfaction in the perioperative period were evaluated. The results showed that the regional homogeneity values were different in different brain regions, but there was no difference in the Z value of functional connectivity P > 0.05 . Compared with the control group, heart rate, mean arterial pressure, awakening time, extubation time, the Riker sedation-agitation scale (SAS) score, and anesthetic dosage were signally decreased in group A and group B, while the Ramsay scores, the postanesthesia care unit (PACU) stay, and anesthesia maintenance time in the two groups was obviously increased P < 0.05 . Compared with group A, the extubation time, the SAS score, PACU stay, and hospital stay were all remarkably reduced in group B, while the nursing satisfaction score was greatly increased P < 0.05 . To sum up, DEX was helpful to safely and effectively reduce the occurrence of emergence agitation in patients under general anesthesia surgery with sevoflurane. Besides, comfortable nursing intervention could further reduce the incidence of emergence agitation in patients with general anesthesia, shorten the length of hospital stay, and improve nursing satisfaction.

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“…• Choice of maintenance anesthetic and/or adjunct agents can help to reduce the likelihood of emergence delirium/ agitation (e.g., administer propofol or precedex rather than midazolam or administer TIVA as opposed to a gas agent). 5,10,23,25,27,28 • As case concludes, call ahead to recovery room/post-anesthesia care unit (PACU) to initiate intervention protocol for emergence of the high-risk patient.…”

Section: Phases Componentsmentioning

confidence: 99%

Perioperative Delirium/Agitation Associated With the Use of Anesthetics and/or Adjunct Agents: A Study of Patient Behaviors, Injuries, and Interventions to Mitigate Risk

Taylor¹,

Pileggi

2021

PatientSaf

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Anesthetics and adjunct agents have a long history of being associated with patients engaging in delirious or agitated behavior in a perioperative setting. Prior to this study, few have explored the topic with a focus on safety for both the patient and staff. We explored the Pennsylvania Patient Safety Reporting System (PA-PSRS) database for event reports to identify bouts of delirium/ agitation associated with anesthetics and/or adjunct agents that occurred during the pre-, intra-, or postoperative period. We identified 97 event reports from 63 healthcare facilities over a two-year period. Patients’ ages ranged from 1 to 91 years and 66% of the patients were reported as male. Also, 8% of the delirium/agitation occurred preoperatively, 8% intraoperatively, and 84% postoperatively. Across all three operative periods, 62% of the reports described dangerous/nonviolent behavior and 26% described dangerous/violent behavior. Additionally, 40% of the event reports described one or more patient injuries (e.g., cardiopulmonary arrest, asphyxiation, hematoma, prolapse/dehiscence, progressive ischemia) and 36% of the patients required additional healthcare services or monitoring (e.g., intra- or interfacility transfer, additional surgical procedure). Finally, 54% of the event reports described patient behavior that created an immediate and high risk of staff harm. Overall, the current study provides novel insight into how delirium/agitation has varying safety implications depending on the operative period. We encourage readers to review Table 5, which proposes a four-phase intervention package to prevent, treat, and de-escalate bouts of delirium/agitation.

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Evaluation of emergence agitation after general anaesthesia in rhinoplasty patients: Inhalation anaesthesia versus total intravenous anaesthesia

Cited by 20 publications

References 18 publications

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

<p>Effects of Adding a Combined Infraorbital and Infratrochlear Nerve Block to General Anaesthesia in Septorhinoplasty</p>

Functional Magnetic Resonance Imaging of Brain Function and Emergence Agitation of Patients with Dexmedetomidine-Assisted General Anesthesia under Comfortable Nursing Intervention

Perioperative Delirium/Agitation Associated With the Use of Anesthetics and/or Adjunct Agents: A Study of Patient Behaviors, Injuries, and Interventions to Mitigate Risk

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