Emergence agitation in pediatric anesthesia: current features.
OBJECTIVE
Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem.


METHODS
MEDLINE and PubMed were searched using the following words: emergence, agitation, incidence, etiology, diagnosis, treatment, children, pediatric, anesthesia.


RESULTS
This study includes a review of potential agitation trigger factors and a proposal for a standardized diagnostic score system, in addition to measures to improve prevention and treatment.


CONCLUSIONS
No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.
Silva
Leopoldo Muniz da
LM
Departamento de Anestesiologia, Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
Braz
Leandro Gobbo
LG
Módolo
Norma Sueli Pinheiro
NS
D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011595:Psychomotor Agitation / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D012307:Risk Factors