title: Routines for reducing the occurrence of emergence agitation during awakening in children, a national survey.
abstract: Emergence agitation following anesthesia in children is not uncommon. It is, although generally self-limiting, associated with both patient and parents distress. We conducted a national survey around the management of behavioral and neurocognitive disturbances after surgery/anesthesia including a case scenario about a child at risk for emergence reaction. Premedication with clonidine or midazolam would have been used 58 and 37% of responders respectively. A propofol based anesthesia was the most common anesthetic technique, however sevoflurane or desflurane was an option for 45 and 8% of responders. Before awakening 65% would have administered an opioid, 48% a low-dose of propofol and 25% clonidine. Sign or symptoms of behavioral disturbance was not assessed by standardize assessment tools. A majority of Swedish anesthesia personnel would undertake some preventive action when handling a child at risk for an emergence reaction, the preventive measure differed and it seems as there is an obvious room for further improvements.
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital, 701 85 Örebro, Sweden.
authors.forename: Pether K
authors.initials: PK
authors.lastname: Jildenstål
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital, 701 85 Örebro, Sweden.
authors.forename: Narinder
authors.initials: N
authors.lastname: Rawal
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital, 701 85 Örebro, Sweden.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hallén
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital, CAMTÖ, Centre for Assessment of Medical Technology in Örebro, Örebro, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Berggren
authors.affiliation: Department of Anesthesiology and Intensive Care, Institution for Clinical Science, Karolinska Institutet, Danderyds Hospital, Stockholm, Sweden.
authors.forename: Jan G
authors.initials: JG
authors.lastname: Jakobsson
keywords: Emergence agitation; Generalanesthesia; Postoperative pain; Postoperative recovery and volatile anesthetics; Premedication; Volatile anesthetics