Emergence delirium following sevoflurane anesthesia in adults: prospective observational study
Background and objectives: Emergence delirium after general anesthesia with sevoflurane has not been frequently reported in adults compared to children. This study aimed to determine the incidence of emergence delirium in adult patients who had anesthesia with sevoflurane as the volatile agent and t...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-05-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001418301714 |
| _version_ | 1811199298740682752 |
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| author | Renair Ramroop Seetharaman Hariharan Deryk Chen |
| author_facet | Renair Ramroop Seetharaman Hariharan Deryk Chen |
| author_sort | Renair Ramroop |
| collection | DOAJ |
| description | Background and objectives: Emergence delirium after general anesthesia with sevoflurane has not been frequently reported in adults compared to children. This study aimed to determine the incidence of emergence delirium in adult patients who had anesthesia with sevoflurane as the volatile agent and the probable risk factors associated with its occurrence. Design & methods: A prospective observational study was conducted in adult patients who had non-neurological procedures and no existing neurological or psychiatric conditions, under general anesthesia. Demographic data such as age, gender, ethnicity and clinical data including ASA physical status, surgical status, intubation attempts, duration of surgery, intraoperative hypotension, drugs used, postoperative pain, rescue analgesia and presence of catheters were recorded. Emergence delirium intensity was measured using the Nursing Delirium Scale (NuDESC). Results: The incidence of emergence delirium was 11.8%. The factors significantly associated with emergence delirium included elderly age (>65) (p = 0.04), emergency surgery (p = 0.04), African ethnicity (p = 0.01), longer duration of surgery (p = 0.007) and number of intubation attempts (p = 0.001). Factors such as gender, alcohol and illicit drug use, and surgical specialty did not influence the occurrence of emergence delirium. Conclusions: The incidence of emergence delirium in adults after general anesthesia using sevoflurane is significant and has not been adequately reported. Modifiable risk factors need to be addressed to further reduce its incidence. Resumo: Justificativa e objetivos: O delirium do despertar após a anestesia geral com sevoflurano não tem sido relatado com frequência em adultos como nas crianças. Este estudo teve como objetivo determinar a incidência de delirium do despertar em pacientes adultos submetidos à anestesia com sevoflurano como agente volátil e os prováveis fatores de risco associados a sua ocorrência. Desenho e métodos: Um estudo observacional prospectivo foi conduzido com pacientes adultos sem distúrbios neurológicos ou psiquiátricos que foram submetidos à anestesia geral para procedimentos não neurológicos. Dados demográficos como idade, sexo, etnia e dados clínicos, incluindo escore ASA, estado cirúrgico, tentativas de intubação, tempo de cirurgia, hipotensão intraoperatória, drogas utilizadas, dor pós-operatória, analgesia de resgate e presença de cateteres foram registrados. A intensidade do delirium do despertar foi medida usando a Escala de Triagem de Delirium em Enfermagem (Nursing Delirium Scale – NuDESC). Resultados: A incidência de delirium do despertar foi de 11,8%. Os fatores significativamente associados ao delirium do despertar incluíram idade avançada (>65) (p = 0,04), cirurgia de emergência (p = 0,04), descendência africana (p = 0,01), tempo maior de cirurgia (p = 0,007) e número de tentativas de intubação (p = 0,001). Fatores como sexo, uso de álcool e drogas ilícitas e especialidade cirúrgica não influenciaram a ocorrência de delirium do despertar. Conclusões: A incidência de delirium do despertar em adultos após a anestesia geral com sevoflurano é significativa e não tem sido relatada adequadamente. Fatores de risco modificáveis precisam ser abordados para reduzir ainda mais sua incidência. Keywords: Emergence delirium, Sevoflurane, Adult patients, Post-anesthesia care, Palavras-chave: Delirium do despertar, Sevoflurano, Pacientes adultos, Cuidados pós-anestésicos |
| first_indexed | 2024-04-12T01:45:40Z |
| format | Article |
| id | doaj.art-0937bf32152e436c8834d4433683d85d |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T01:45:40Z |
| publishDate | 2019-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-0937bf32152e436c8834d4433683d85d2022-12-22T03:53:05ZengElsevierBrazilian Journal of Anesthesiology0104-00142019-05-01693233241Emergence delirium following sevoflurane anesthesia in adults: prospective observational studyRenair Ramroop0Seetharaman Hariharan1Deryk Chen2Eric Williams Medical Sciences Complex, The University of the West Indies, Faculty of Medical Sciences, Mount Hope, Trinidad and TobagoCorresponding author.; Eric Williams Medical Sciences Complex, The University of the West Indies, Faculty of Medical Sciences, Mount Hope, Trinidad and TobagoEric Williams Medical Sciences Complex, The University of the West Indies, Faculty of Medical Sciences, Mount Hope, Trinidad and TobagoBackground and objectives: Emergence delirium after general anesthesia with sevoflurane has not been frequently reported in adults compared to children. This study aimed to determine the incidence of emergence delirium in adult patients who had anesthesia with sevoflurane as the volatile agent and the probable risk factors associated with its occurrence. Design & methods: A prospective observational study was conducted in adult patients who had non-neurological procedures and no existing neurological or psychiatric conditions, under general anesthesia. Demographic data such as age, gender, ethnicity and clinical data including ASA physical status, surgical status, intubation attempts, duration of surgery, intraoperative hypotension, drugs used, postoperative pain, rescue analgesia and presence of catheters were recorded. Emergence delirium intensity was measured using the Nursing Delirium Scale (NuDESC). Results: The incidence of emergence delirium was 11.8%. The factors significantly associated with emergence delirium included elderly age (>65) (p = 0.04), emergency surgery (p = 0.04), African ethnicity (p = 0.01), longer duration of surgery (p = 0.007) and number of intubation attempts (p = 0.001). Factors such as gender, alcohol and illicit drug use, and surgical specialty did not influence the occurrence of emergence delirium. Conclusions: The incidence of emergence delirium in adults after general anesthesia using sevoflurane is significant and has not been adequately reported. Modifiable risk factors need to be addressed to further reduce its incidence. Resumo: Justificativa e objetivos: O delirium do despertar após a anestesia geral com sevoflurano não tem sido relatado com frequência em adultos como nas crianças. Este estudo teve como objetivo determinar a incidência de delirium do despertar em pacientes adultos submetidos à anestesia com sevoflurano como agente volátil e os prováveis fatores de risco associados a sua ocorrência. Desenho e métodos: Um estudo observacional prospectivo foi conduzido com pacientes adultos sem distúrbios neurológicos ou psiquiátricos que foram submetidos à anestesia geral para procedimentos não neurológicos. Dados demográficos como idade, sexo, etnia e dados clínicos, incluindo escore ASA, estado cirúrgico, tentativas de intubação, tempo de cirurgia, hipotensão intraoperatória, drogas utilizadas, dor pós-operatória, analgesia de resgate e presença de cateteres foram registrados. A intensidade do delirium do despertar foi medida usando a Escala de Triagem de Delirium em Enfermagem (Nursing Delirium Scale – NuDESC). Resultados: A incidência de delirium do despertar foi de 11,8%. Os fatores significativamente associados ao delirium do despertar incluíram idade avançada (>65) (p = 0,04), cirurgia de emergência (p = 0,04), descendência africana (p = 0,01), tempo maior de cirurgia (p = 0,007) e número de tentativas de intubação (p = 0,001). Fatores como sexo, uso de álcool e drogas ilícitas e especialidade cirúrgica não influenciaram a ocorrência de delirium do despertar. Conclusões: A incidência de delirium do despertar em adultos após a anestesia geral com sevoflurano é significativa e não tem sido relatada adequadamente. Fatores de risco modificáveis precisam ser abordados para reduzir ainda mais sua incidência. Keywords: Emergence delirium, Sevoflurane, Adult patients, Post-anesthesia care, Palavras-chave: Delirium do despertar, Sevoflurano, Pacientes adultos, Cuidados pós-anestésicoshttp://www.sciencedirect.com/science/article/pii/S0104001418301714 |
| spellingShingle | Renair Ramroop Seetharaman Hariharan Deryk Chen Emergence delirium following sevoflurane anesthesia in adults: prospective observational study Brazilian Journal of Anesthesiology |
| title | Emergence delirium following sevoflurane anesthesia in adults: prospective observational study |
| title_full | Emergence delirium following sevoflurane anesthesia in adults: prospective observational study |
| title_fullStr | Emergence delirium following sevoflurane anesthesia in adults: prospective observational study |
| title_full_unstemmed | Emergence delirium following sevoflurane anesthesia in adults: prospective observational study |
| title_short | Emergence delirium following sevoflurane anesthesia in adults: prospective observational study |
| title_sort | emergence delirium following sevoflurane anesthesia in adults prospective observational study |
| url | http://www.sciencedirect.com/science/article/pii/S0104001418301714 |
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