[Emergence agitation in pediatric anesthesia].
Emergence agitation following general anesthesia in children is an evolving problem, since sevoflurane has become a popular anesthetic for pediatric anesthesia. Several studies comparing incidence of emergence agitation between halothane and sevoflurane showed that sevoflurane anesthesia would result in higher chance of emergence agitation. The reasons of higher incidence of emergence agitation following sevoflurane anesthesia remain unknown. Other risk factors of emergence agitation include age of patients, operative procedure, pain, preoperative anxiety and so on. Several methods are advocated to prevent emergence agitation. The aggressive treatment of surgical pain is essential to avoid screaming on emergence. In addition, varieties of medication, including opioid, sedatives and alpha-2 agonist, have been tried with various success. The avoidance of sevoflurane use for maintenance of anesthesia could be a major contributing factor to reduce the risk of emergence agitation. In the light of quality of emergence, propofol anesthesia seems to be favorable for sedation in imaging procedures. Emergence agitation should be treated appropriately, since it could injure the patient him/herself or caregiver. The calm wake-up from general anesthesia will greatly enhance the parental satisfaction to anesthesia and surgery.
Kuratani
Norifumi
N
Department of Anesthesiology, Saitama Medical School, Saitama 350-0495.
D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D002648:Child; D006221:Halothane / Q000009:adverse effects; D006801:Humans; D008738:Methyl Ethers / Q000009:adverse effects; D011595:Psychomotor Agitation / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D000077149:Sevoflurane
D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane