Emergence delirium in children: a Brazilian survey

Braz J Anesthesiol. 2022 Mar-Apr;72(2):207-212. doi: 10.1016/j.bjane.2020.12.029. Epub 2021 Apr 3.

Abstract

Background: Pediatric emergence delirium is characterized by a disturbance of a child's awareness during the early postoperative period that manifests as disorientation, altered attention and perception. The incidence of emergence delirium varies between 18% and 80% depending on risk factors and how it is measured. Reports from Canada, Germany, Italy, United Kingdom, and France demonstrated a wide range of preventive measures and definitions, indicating that there is a lack of clarity regarding emergence delirium. We aimed to assess the practices and beliefs among Brazilian anesthesiologists regarding emergence delirium.

Methods: A web-based survey was developed using REDCap®. A link and QR Code were sent by email to all Brazilian anesthesiologists associated with the Brazilian Society of Anesthesiology (SBA).

Results: We collected 671 completed questionnaires. The majority of respondents (97%) considered emergence delirium a relevant adverse event. Thirty-two percent of respondents reported routinely administrating medication to prevent emergence delirium, with clonidine (16%) and propofol (15%) being the most commonly prescribed medications. More than 70% of respondents reported a high level of patient and parent anxiety, a previous history of emergence delirium, and untreated pain as risk factors for emergence delirium. Regarding treatment, thirty-five percent of respondents reported using propofol, followed by midazolam (26%).

Conclusion: Although most respondents considered emergence delirium a relevant adverse event, only one-third of them routinely applied preventive measures. Clonidine and propofol were the first choices for pharmacological prevention. For treatment, propofol and midazolam were the most commonly prescribed medications.

Keywords: Anesthesia; Child; Emergence delirium; Survey.

MeSH terms

  • Anesthesia Recovery Period
  • Brazil / epidemiology
  • Child
  • Clonidine
  • Emergence Delirium* / epidemiology
  • Emergence Delirium* / prevention & control
  • Humans
  • Midazolam
  • Propofol*
  • Surveys and Questionnaires

Substances

  • Clonidine
  • Midazolam
  • Propofol