Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar-Apr;72(2):207-212.
doi: 10.1016/j.bjane.2020.12.029. Epub 2021 Apr 3.

Emergence delirium in children: a Brazilian survey

Vinícius Caldeira Quintão  1 , Charlize Kessin de Oliveira Sales  2 , Estefania Morales Herrera  2 , Richard K Ellerkmann  3 , H David Rosen  4 , Maria José Carvalho Carmona  2
Affiliations

Emergence delirium in children: a Brazilian survey

Vinícius Caldeira Quintão et al. Braz J Anesthesiol. 2022 Mar-Apr.

Abstract

Background: Pediatric emergence delirium is characterized by a disturbance of a child's awareness during the early postoperative period that manifests as disorientation, altered attention and perception. The incidence of emergence delirium varies between 18% and 80% depending on risk factors and how it is measured. Reports from Canada, Germany, Italy, United Kingdom, and France demonstrated a wide range of preventive measures and definitions, indicating that there is a lack of clarity regarding emergence delirium. We aimed to assess the practices and beliefs among Brazilian anesthesiologists regarding emergence delirium.

Methods: A web-based survey was developed using REDCap®. A link and QR Code were sent by email to all Brazilian anesthesiologists associated with the Brazilian Society of Anesthesiology (SBA).

Results: We collected 671 completed questionnaires. The majority of respondents (97%) considered emergence delirium a relevant adverse event. Thirty-two percent of respondents reported routinely administrating medication to prevent emergence delirium, with clonidine (16%) and propofol (15%) being the most commonly prescribed medications. More than 70% of respondents reported a high level of patient and parent anxiety, a previous history of emergence delirium, and untreated pain as risk factors for emergence delirium. Regarding treatment, thirty-five percent of respondents reported using propofol, followed by midazolam (26%).

Conclusion: Although most respondents considered emergence delirium a relevant adverse event, only one-third of them routinely applied preventive measures. Clonidine and propofol were the first choices for pharmacological prevention. For treatment, propofol and midazolam were the most commonly prescribed medications.

Keywords: Anesthesia; Child; Emergence delirium; Survey.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Frequency of preferences for preanesthetic or intraoperative anesthetic drugs to prevent emergence delirium.
See this image and copyright information in PMC

References

    1. Somaini M., Sahillioğlu E., Marzorati C., Lovisari F., Engelhardt T., Ingelmo P.M. Emergence delirium, pain or both? A challenge for clinicians. Paediatr Anaesth. 2015;25:524–529. - PubMed
    1. Aldecoa C., Bettelli G., Bilotta F., et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34:192–214. - PubMed
    1. Sikich N., Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale. Anesthesiology. 2004;100:1138–1145. - PubMed
    1. Huett C., Baehner T., Erdfelder F., et al. Prevention and therapy of pediatric emergence delirium: a national survey. Paediatr Drugs. 2017;19:147–153. - PubMed
    1. Watcha M.F., Ramirez-Ruiz M., White P.F., Jones M.B., Lagueruela R.G., Terkonda R.P. Perioperative effects of oral ketorolac and acetaminophen in children undergoing bilateral myringotomy. Can J Anaesth. 1992;39:649–654. - PubMed

LinkOut - more resources