Emergence delirium

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Emergence delirium
Classification and external resources
ICD-10 F13.4
ICD-9 292.81

Emergence delirium (sometimes referred to as agitated emergence, emergence agitation, emergence excitement, or postanesthetic excitement) is a condition in which emergence from general anesthesia is accompanied by psychomotor agitation. Some see a relation to pavor nocturnus [1] while other see a relation to the excitement stage of anesthesia.

In children[edit]

The pediatric anesthesia emergence delirium scale may be used to measure the severity of this condition in children.[2]

Epidemiology[edit]

The overall incidence of emergence delirium is 5.3%, with a significantly greater incidence (12-13%) in children. The incidence of emergence delirium after halothane, isoflurane, sevoflurane or desflurane ranges from 2-55%.[3] Most emergence delirium in the literature describes agitated emergence. Unless a delirium detection tool is used, it is difficult to distinguish if the agitated emergence from anesthesia was from delirium or pain or fear, etc. A research study of 400 adult patients emerging from general anesthesia in the PACU were assessed for delirium using the Confusion Assessment Method for the ICU (CAM-ICU) found rates of emergence delirium of 31% at PACU admission with rates declining to 8% by 1 hour.[4]

References[edit]

  1. ^ http://www.asa2012.com/PDFs_abstracts/davidson.pdf
  2. ^ Sikich, N; Lerman, J (2004). "Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale". Anesthesiology 100 (5): 1138–45. doi:10.1097/00000542-200405000-00015. PMID 15114210. 
  3. ^ Mason, LJ (2004). "Pitfalls of Pediatric Anesthesia: Emergence Delirium". Richmond, Virginia: Society for Pediatric Anestheisa. Retrieved 2012-06-21. 
  4. ^ E. Card, P. Pandharipande, C. Tomes, C. Lee, J. Wood, D. Nelson, A. Graves, A. Shintani, E. W. Ely and C. Hughes (2014) Emergence from general anaesthesia and evolution of delirium signs in the post-anaesthesia care unit. Br. J. Anaesth. (2014) doi: 10.1093/bja/aeu442 First published online: December 23, 2014

Further reading[edit]

  • Artusio JF, Jr. (April 1964). "Anesthesia and its immediate postoperative complications". Surg Clin North Am. 44: 493–504. PMID 14180336.