Risk factors of emergence agitation after general anesthesia in children: multicenter study

Park, Sang Yoong; Chung, Chan Jong; Park, Jae Won; Lee, Seung Yoon; Choi, So Ron

Abstract

BACKGROUND
Emergence agitation (EA) frequently occurs after general anesthesia in children. This multicenter study was investigated to determine incidence and risk factors of EA after general anesthesia in children.
METHODS
This prospective study evaluated 816 pediatric patients receiving elective surgery under general anesthesia at 10 university hospitals. Emotional and behavioral status of the patients upon emergence from anesthesia was assessed by Aono's four point scale. Those with an Aono's four point scale of 3 or 4 were considered to be affected by EA. Patient physical, anesthetic, and surgical variables were analyzed to find the risk factors of EA.
RESULTS
One-hundred-fifty-two children (18.6%) developed EA. No relationships between the incidence of EA and age, sex, ASA physical status, premedicants, anesthetic induction agents, anesthetic maintenance methods, or postoperative analgesia were found. A multivariate analysis identified preanesthetic emotional status (OR = 1.774, P < 0.001), perioperative airway complication (OR = 1.867, P < 0.007) and rhinolaryngologic surgery (OR = 1.597, P < 0.017) as risk factors of EA.
CONCLUSIONS
Preanesthetic emotional status, perioperative airway complication and rhinolaryngologic surgery were risk factors of EA after general anesthesia in children.