The Incidence and Associated Risk Factors of Emergence Agitation in Pediatric Patients after General Anesthesia at Addis Ababa Governmental Hospitals from February- May 2021 (Prospective Observational Study)
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Date
2021-07
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Addis Ababa University
Abstract
Background: Emergence agitation (EA) is a post-operative complication immediately after surgery and characterized by phenomenon that includes restlessness, disorientation, non-purposeful movement,
inconsolability, and thrashing during early recovery from general anesthesia. The occurrence rate of emergence agitation is high, which may lead to prolongation of hospital stay, physical damage and as well as psychological trauma which may need intervention
Objective: To assess the incidence and associated risk factors of emergence agitation in pediatric patients aged 2-12 years old after general anesthesia at Addis Ababa governmental hospitals, Addis Ababa, Ethiopia.
Methods: A prospective observational study was conducted at selected Addis Ababa governmental hospitals, Addis Ababa, Ethiopia from February 1, 2021 to May 30, 2021. Elective patients with ASA Iand II, age 2-12 years old patients who Underwent General Anesthesia had been studied. Data collection
methods include anesthesia record sheets, obtained information from responsible anesthetists and, PACU
follow-up by using a pre-tested questionnaire. Collected data then inserted and analyzed using SPSS version 26. Bivariate logistic regression analysis was carried out to examine the predictor of the outcome variable. Variables with a p-value less than 0.2 on Bivariate logistic analysis were taken to multivariablelogistic regression analysis and a p-value of <0.05 considered statistically significant.
Results: The incidence of post-operative emergence agitation in this study was 49 %( 197/402). Age (2-6 years old) [AOR= 1.71, (95%CI): (1.02-2.88], EENT surgery [AOR=11.62, (95%CI): (3.2-41.99)] uncooperative and restless parental separation behavior [AOR=2.22, (95%CI) (1.14-9.11)], Perioperative
regional block [AOR=0.33, (95%CI): (0.15-0.75). duration of surgery < 1 hour [AOR=2.35, (95%CI): (1.21-4.55)], moderate pain [AOR=3.77, (95%CI): (1.57-9.07)] and severe pain [AOR=11.2, (95%CI): (4.46-28.13)] were significantly associated with post-operative emergence agitation after general anesthesia.
Conclusion and Recommendations: Incidence of post-operative emergence agitation after general anesthesia in the pediatric age group was high in Addis Ababa governmental hospital. Age, surgical
specialty, parental separation behavior, duration of surgery and pain was predictive factors. But giving perioperative regional block had a protective effect. So, all anesthetists and PACU nurses should know the risk factors associated with post-operative emergence agitation after general anesthesia, and able to develop a strategy to manage the problem. Giving regional block as pain management should be considered.
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Keywords
Emergence agitation, general anesthesia, pediatric anesthesia