title: Independent predictors of delay in emergence from general anesthesia.
abstract: Some patients with intellectual disabilities spend longer than others in emergence from ambulatory general anesthesia for dental treatment. Although antiepileptic drugs and anesthetics might be involved, an independent predictor for delay of the emergence remains unclear. Thus, a purpose of this study is to identify independent factors affecting the delay of emergence from general anesthesia. This was a retrospective cohort study in dental patients with intellectual disabilities. Patients in need of sedative premedication were removed from participants. The outcome was time until emergence from general anesthesia. Stepwise multivariate regression analysis was used to extract independent factors affecting the outcome. Antiepileptic drugs and anesthetic parameters were included as predictor variables. The study included 102 cases. Clobazam, clonazepam, and phenobarbital were shown to be independent determinants of emergence time. Parameters relating to anesthetics, patients' backgrounds, and dental treatment were not independent factors. Delay in emergence time in ambulatory general anesthesia is likely to be related to the antiepileptic drugs of benzodiazepine or barbiturates in patients with intellectual disability.
authors: Department of Dental Anesthesiology and.
authors: Shigeru
authors: S
authors: Maeda
authors: Yumiko
authors: Y
authors: Tomoyasu
authors: Hitoshi
authors: H
authors: Higuchi
authors: Minako
authors: M
authors: Ishii-Maruhama
authors: Masahiko
authors: M
authors: Egusa
authors: Takuya
authors: T
authors: Miyawaki
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000927:Anticonvulsants / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D000078306:Clobazam; D002998:Clonazepam / Q000627:therapeutic use; D015331:Cohort Studies; D055191:Delayed Emergence from Anesthesia / Q000209:etiology*; D003730:Dental Care for Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D010634:Phenobarbital / Q000627:therapeutic use; D010672:Phenytoin / Q000627:therapeutic use; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil; D012189:Retrospective Studies; D012307:Risk Factors; D000077149:Sevoflurane; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000927:Anticonvulsants; D008738:Methyl Ethers; D010880:Piperidines; D001569:Benzodiazepines; D000078306:Clobazam; D000077149:Sevoflurane; D002998:Clonazepam; D014635:Valproic Acid; D010672:Phenytoin; D000077208:Remifentanil; D015742:Propofol; D010634:Phenobarbital
keywords: Anticonvulsants; Barbituric acid; Benzodiazepines; Day case; Propofol; Remifentanil