Emergence delirium in children: a Brazilian survey

• Published in: Brazilian Journal of Anesthesiology 2022-03, Vol.72 (2), p.207-212
• Main Authors: Quintão, Vinícius Caldeira, Sales, Charlize Kessin de Oliveira, Herrera, Estefania Morales, Ellerkmann, Richard K., Rosen, H. David, Carmona, Maria José Carvalho
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia Recovery Period; ANESTHESIOLOGY; Brazil - epidemiology; Child; Clonidine; Emergence delirium; Emergence Delirium - epidemiology; Emergence Delirium - prevention & control; Humans; MEDICINE, GENERAL & INTERNAL; Midazolam; Original Investigation; Propofol; Survey; Surveys and Questionnaires
• ISSN: 0104-0014; 2352-2291; 0104-0014; 2352-2291
• DOI: 10.1016/j.bjane.2020.12.029

Pediatric emergence delirium is characterized by a disturbance of a child’s awareness during the early postoperative period that manifests as disorientation, altered attention and perception. The incidence of emergence delirium varies between 18% and 80% depending on risk factors and how it is measured. Reports from Canada, Germany, Italy, United Kingdom, and France demonstrated a wide range of preventive measures and definitions, indicating that there is a lack of clarity regarding emergence delirium. We aimed to assess the practices and beliefs among Brazilian anesthesiologists regarding emergence delirium. A web-based survey was developed using REDCap®. A link and QR Code were sent by email to all Brazilian anesthesiologists associated with the Brazilian Society of Anesthesiology (SBA). We collected 671 completed questionnaires. The majority of respondents (97%) considered emergence delirium a relevant adverse event. Thirty-two percent of respondents reported routinely administrating medication to prevent emergence delirium, with clonidine (16%) and propofol (15%) being the most commonly prescribed medications. More than 70% of respondents reported a high level of patient and parent anxiety, a previous history of emergence delirium, and untreated pain as risk factors for emergence delirium. Regarding treatment, thirty-five percent of respondents reported using propofol, followed by midazolam (26%). Although most respondents considered emergence delirium a relevant adverse event, only one-third of them routinely applied preventive measures. Clonidine and propofol were the first choices for pharmacological prevention. For treatment, propofol and midazolam were the most commonly prescribed medications.