Emergency delirium in pediatric anesthesia

Abstract

Emergency delirium (ED) is characterized by inattention, irritability, disorientation, and hyperactivity that occurs in the period of early anesthetic awakening. It resolves spontaneously and apparently without sequelae, but it is a cause of anxiety for parents who see their children not responding in the way they normally would. The incidence reported in the literature is variable and depends on the definition used, but it is described between 10%-80%. It is associated with the use of powerful halogenated gases, such as sevoflurane and desflurane. Some risk factors for its appearance are age, type of surgery, duration of the intervention and preoperative anxiety. Its diagnosis is clinical and other causes of agitation must be ruled out prior to its diagnosis. There are various pharmacological and non-pharmacological strategies that have been tried to prevent its appearance. The treatment is pharmacological using drugs that produce transient sedation, such as propofol, opioids or dexmedetomidine.