Emergence delirium or agitation
Patient (condition)
 
Aliases:
Emergence delirium
Emergence agitation

Topic aliases are alternate phrasings for a particular topic.


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Delirium is a psychiatric syndrome that includes perceptual disturbances, hallucinations, and psychomotor agitation. The term “delirium” is often replaced with the terms “agitation” or “excitation” in children as it is often difficult to evaluate a child's psychological state at emergence. Agitation can be due to pain/physiological compromise/anxiety. Delirium may be confused with agitation, but it may also be a cause of agitation. doi.org/10.1213/01.ane.00...

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According to this observational analysis the absence of eye contact and awareness of surroundings in preschool children are useful in distinguishing ED from EA academic.oup.com/bja/arti...

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Reduce by minimising fasting time

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Minimise by avoiding hypovolemia. Consider administering intravenous fluids (20ml/kg). #ref

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Ketamine 0.25 mg/kg during dental surgery in 4-7yr olds (with sevoflurane) reduced the incidence of emergence agitation from 34% to 16% in this RCT of 80 children. refl.in/fq

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Was the control group simply underanalgesed? If so, this might explain why they have a higher incidence of agitation, although it depends on how painful "corrective dental surgery" is.
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Administer rescue drugs if necessary in recovery

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Aug 19, 2011
Fentanil 1-2mcg/kg or Propofol 0.5-1mg/kg refl.in/ec refl.in/eb
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Minimise by reducing environmental stimuli in recovery refl.in/ed

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Differentiate emergence delirium (disorientation, perceptual alteration, hyperactive motor behaviour) from emergence agitation (pain, hypoxia, hypovolemia, hunger) #ref

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Rule out emergence agitation by treating pain, hypoxia, and hypothermia.

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