Delayed Emergence from Anesthesia: What We Know and How We Act
Marco Cascella,1 Sabrina Bimonte,1 Raffaela Di Napoli2 1Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Naples, Italy; 2Department of Anesthesiology, Institut Jules Bordet, Université Libre De Bruxelles, B...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2020-11-01
|
| Series: | Local and Regional Anesthesia |
| Subjects: | |
| Online Access: | https://www.dovepress.com/delayed-emergence-from-anesthesia-what-we-know-and-how-we-act-peer-reviewed-article-LRA |
| _version_ | 1811293102192721920 |
|---|---|
| author | Cascella M Bimonte S Di Napoli R |
| author_facet | Cascella M Bimonte S Di Napoli R |
| author_sort | Cascella M |
| collection | DOAJ |
| description | Marco Cascella,1 Sabrina Bimonte,1 Raffaela Di Napoli2 1Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Naples, Italy; 2Department of Anesthesiology, Institut Jules Bordet, Université Libre De Bruxelles, Bruxelles 1000, BelgiumCorrespondence: Marco CascellaDivision of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Via Semmola 1. 80100, Naples, ItalyTel +39 0815903221Fax +39 0815903778Email m.cascella@istitutotumori.na.itAbstract: The emergence from anesthesia is the stage of general anesthesia featuring the patient’s progression from the unconsciousness status to wakefulness and restoration of consciousness. This complex process has precise neurobiology which differs from that of induction. Despite the medications commonly used in anesthesia allow recovery in a few minutes, a delay in waking up from anesthesia, called delayed emergence, may occur. This phenomenon is associated with delays in the operating room, and an overall increase in costs. Together with the emergence delirium, the phenomenon represents a manifestation of inadequate emergence. Nevertheless, in delayed emergence, the transition from unconsciousness to complete wakefulness usually occurs along a normal trajectory, although slowed down. On the other hand, this awakening trajectory could proceed abnormally, possibly culminating in the manifestation of emergence delirium. Clinically, delayed emergence often represents a challenge for clinicians who must make an accurate diagnosis of the underlying cause to quickly establish appropriate therapy. This paper aimed at presenting an update on the phenomenon, analyzing its causes. Diagnostic and therapeutic strategies are addressed. Finally, therapeutic perspectives on the “active awakening” are reported.Keywords: general anesthesia, anesthesia emergence, delayed emergence, emergence delirium |
| first_indexed | 2024-04-13T04:56:28Z |
| format | Article |
| id | doaj.art-b9d8f629a8494f4bb670877bef96b5f1 |
| institution | Directory Open Access Journal |
| issn | 1178-7112 |
| language | English |
| last_indexed | 2024-04-13T04:56:28Z |
| publishDate | 2020-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Local and Regional Anesthesia |
| spelling | doaj.art-b9d8f629a8494f4bb670877bef96b5f12022-12-22T03:01:29ZengDove Medical PressLocal and Regional Anesthesia1178-71122020-11-01Volume 1319520658963Delayed Emergence from Anesthesia: What We Know and How We ActCascella MBimonte SDi Napoli RMarco Cascella,1 Sabrina Bimonte,1 Raffaela Di Napoli2 1Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Naples, Italy; 2Department of Anesthesiology, Institut Jules Bordet, Université Libre De Bruxelles, Bruxelles 1000, BelgiumCorrespondence: Marco CascellaDivision of Anesthesia and Pain Medicine, Istituto Nazionale Tumori – IRCCS – “Fondazione G. Pascale, Via Semmola 1. 80100, Naples, ItalyTel +39 0815903221Fax +39 0815903778Email m.cascella@istitutotumori.na.itAbstract: The emergence from anesthesia is the stage of general anesthesia featuring the patient’s progression from the unconsciousness status to wakefulness and restoration of consciousness. This complex process has precise neurobiology which differs from that of induction. Despite the medications commonly used in anesthesia allow recovery in a few minutes, a delay in waking up from anesthesia, called delayed emergence, may occur. This phenomenon is associated with delays in the operating room, and an overall increase in costs. Together with the emergence delirium, the phenomenon represents a manifestation of inadequate emergence. Nevertheless, in delayed emergence, the transition from unconsciousness to complete wakefulness usually occurs along a normal trajectory, although slowed down. On the other hand, this awakening trajectory could proceed abnormally, possibly culminating in the manifestation of emergence delirium. Clinically, delayed emergence often represents a challenge for clinicians who must make an accurate diagnosis of the underlying cause to quickly establish appropriate therapy. This paper aimed at presenting an update on the phenomenon, analyzing its causes. Diagnostic and therapeutic strategies are addressed. Finally, therapeutic perspectives on the “active awakening” are reported.Keywords: general anesthesia, anesthesia emergence, delayed emergence, emergence deliriumhttps://www.dovepress.com/delayed-emergence-from-anesthesia-what-we-know-and-how-we-act-peer-reviewed-article-LRAgeneral anesthesiaanesthesia emergencedelayed emergenceemergence delirium |
| spellingShingle | Cascella M Bimonte S Di Napoli R Delayed Emergence from Anesthesia: What We Know and How We Act Local and Regional Anesthesia general anesthesia anesthesia emergence delayed emergence emergence delirium |
| title | Delayed Emergence from Anesthesia: What We Know and How We Act |
| title_full | Delayed Emergence from Anesthesia: What We Know and How We Act |
| title_fullStr | Delayed Emergence from Anesthesia: What We Know and How We Act |
| title_full_unstemmed | Delayed Emergence from Anesthesia: What We Know and How We Act |
| title_short | Delayed Emergence from Anesthesia: What We Know and How We Act |
| title_sort | delayed emergence from anesthesia what we know and how we act |
| topic | general anesthesia anesthesia emergence delayed emergence emergence delirium |
| url | https://www.dovepress.com/delayed-emergence-from-anesthesia-what-we-know-and-how-we-act-peer-reviewed-article-LRA |
| work_keys_str_mv | AT cascellam delayedemergencefromanesthesiawhatweknowandhowweact AT bimontes delayedemergencefromanesthesiawhatweknowandhowweact AT dinapolir delayedemergencefromanesthesiawhatweknowandhowweact |