title: [Predisposing factors and prevention of emergence agitation].
abstract: Agitation during the emergence from general anesthesia is a great post-operative problem that often injures the patients themselves and requires the medical staff to restrain and calm the patients. The predisposing factors for emergence agitation include anesthesia, operation, and patient. Sevoflurane anesthesia results in higher incidence of emergence agitation than halothane, because of the rapid emergence, and its effects on central nervous system inducing convulsion and post-operative behavioral changes. The otorhinolaryngologic and ophthalmologic surgeries, post-operative pain, young age, pre-operative anxiety, no past surgical history, and adjustment disorder of patients are risk factors for emergence agitation. The change from sevoflurane to propofol during anesthesia maintenance is a contributing factor to reduce incidence of emergence agitation. The medications including opioids, midazolam, alpha-2 agonists, ketamine, non-steroidal anti-inflammatory drugs, nitrous oxide, and propofol, and aggressive nerve block such as caudal epidural block for post-operative sedation and analgesia are effective to avoid incidence of emergence agitation. The calm emergence following general anesthesia would decrease the self-injuring behavior, and enhance the parent and caregiver satisfaction in general anesthesia and surgery.
authors.affiliation: Department of Anesthesiology, Teikyo University School of Medicine, Tokyo 173-8605.
authors.forename: Ju
authors.initials: J
authors.lastname: Mizuno
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakata
authors.forename: Shigeho
authors.initials: S
authors.lastname: Morita
authors.forename: Hideko
authors.initials: H
authors.lastname: Arita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hanaoka
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; 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
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D006221:Halothane