Prevention of Emergence Agitation with Ketamine in Rhinoplasty

Demir, Cansun; Yüzkat, Nureddin

doi:10.1007/s00266-018-1103-4

Cited by 40 publications

(59 citation statements)

References 23 publications

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“…observational study of children, sex was not associated with the occurrence of EA [54]. Conversely, several studies have shown that male sex is associated with EA in adults [3,8,38,41,55,56]. The higher rate of EA in men is explained by lower pain tolerance and a significant association between postoperative pain and male sex [41,57].…”

Section: Sexmentioning

confidence: 95%

“…EA is reportedly more common in children than in adults [38,45,46]. In a study of children aged 2 -12 years, the incidence of EA was inversely correlated with age [47].…”

Section: Agementioning

confidence: 98%

“…Although EA has been reported despite pain-free procedures and may occur regardless of pain intensity, it is a major risk factor for EA in both children and adults [3,6,9,11,38,69]. These findings indicate that EA and postoperative pain are separate clinical phenomena; however, it is difficult to distinguish between EA and behavioral changes due to postoperative pain [70,71].…”

Section: Painmentioning

confidence: 98%

Section: Proposed Risk Factors For Emergence Agitationmentioning

confidence: 99%

“…These findings indicate that EA and postoperative pain are separate clinical phenomena; however, it is difficult to distinguish between EA and behavioral changes due to postoperative pain [70,71]. In adults, when postoperative pain was assessed with a numerical rating scale, a score ≥ 5 points was found to increase the risk of EA [21,38,39]. Nonetheless, EA may increase postoperative pain.…”

Section: Painmentioning

confidence: 99%

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Emergence agitation: current knowledge and unresolved questions

Lee

Sung

2020

Korean J Anesthesiol

100

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This article is protected by copyright of Korean Journal of Anesthesiology. All rights reserved. Emergence agitation (EA), which is also referred to as emergence delirium, can lead to clinically significant consequences. The mechanism of EA remains unclear. Proposed contributors to EA include age, male sex, type of surgery, emergency operation, use of inhalational anesthetics with low blood-gas partition coefficients, long duration of surgery, anticholinergics, premedication with benzodiazepines, voiding urgency, postoperative pain, and the presence of invasive devices. If preor intraoperative objective monitoring could predict the occurrence of agitation during emergence, this would help to reduce the adverse consequences of EA. Several tools are available for assessing EA; however, its incidence varies considerably according to the assessment tool and definition of EA used, due to the absence of standardized clinical research practice guidelines. Total intravenous anesthesia, propofol, μ-opioid agonists, N-methyl-D-aspartate receptor antagonists, nefopam, α2adrenoreceptor agonists, regional analgesia, multimodal analgesia, parent-present induction, and preoperative education for surgery may contribute to prevention of EA. However, it is difficult to identify patients at high risk for EA and to properly apply EA prevention methods in various clinical situations, because both risk factors and preventive strategies often show inconsistent results depending on the methodology of the study and the patients assessed. This review discusses the most important research topics related to EA and directions for future research.

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Section: Sexmentioning

confidence: 95%

“…EA is reportedly more common in children than in adults [38,45,46]. In a study of children aged 2 -12 years, the incidence of EA was inversely correlated with age [47].…”

Section: Agementioning

confidence: 98%