Experiences of paediatric emergence delirium - from parents' and a child's perspective

Abstract

Background: Emergence delirium is a complex behaviour of perceptual disturbances that may occur after general anaesthesia in children. These children often exhibit delusions, confusion, restlessness and involuntary physical activity. They cry and are almost impossible to console. Research has mainly focused on comparing different medication agents in the occurrence of and dealing with emergence delirium. However, less is known about parents' experiences of emergence delirium during the recovery process, and there is hardly any research concerning the children's experiences.

Aims: The primary aim of this study was to describe parents' experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. A secondary aim was to describe children's experiences of having been in this condition.

Method: A qualitative research approach with thematic analysis was applied. The study was conducted at two county hospitals in southern Sweden. A total of 16 parents and one child were interviewed.

Results: Watching their child demonstrate emergence delirium made parents feel as if they were encountering an incomprehensible scenario. They experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief, and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child, gave hope and energy. The child confirmed the unexpected and uncontrolled behaviour described by parents. She clearly remembered being 'wild' and out of control.

Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. It is of great importance for healthcare staff to be aware of the parental difficulties it may cause and what is experienced as relieving, such as receiving information and staff members being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium; experiences; paediatrics; parents; postoperative care.