EMERGENCE AGITATION IN CHILDREN

Eckenhoff et al first described emergence agitation (EA) in the early 1960‟s. Children anesthetized with ether, cyclopropane, or ketamine undergoing tonsillectomy, thyroidectomy and circumcision experienced crying, thrashing and disorientation during emergence from anesthesia1. Today, approximately 4 million children undergo anesthesia each year and EA has been identified as a significant problem in children recovering from anesthesia with a reported incidence ranging between 10-80%2-5. EA manifests with restlessness and disorientation and may cause injury to the child, disruption of the surgical site and dressing, drains, or even removal of intravenous catheters. Extra nursing care especially in the PACU is needed. Medication given to treat EA may delay discharge from the PACU and sometimes from the hospital. Since 1960, this topic has been studied and investigated with multiple comparative studies of inhalational and intravenous anesthetics, effects of adjuvants to general anesthesia; and different assessment tools have been described. In this review, we will discuss the most recent updates on the topic and point out the controversies present despite ongoing clinical research.