scholarly journals Risk factors of emergence agitation after general anesthesia in adult patients

2016 ◽  
Vol 11 (4) ◽  
pp. 410-416 ◽  
Author(s):  
Jong Cheol Rim ◽  
Jung A Kim ◽  
Jeong In Hong ◽  
Sang Yoong Park ◽  
Jong Hwan Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Adult Patients ◽  
Emergence Agitation

scholarly journals Risk factors of inadequate emergence following general anesthesia with an emphasis on patients with substance dependence history

2020 ◽  
Vol 73 (4) ◽  
pp. 302-310 ◽  
Author(s):  
Jalil Makarem ◽  
Amir Hossein larijani ◽  
Babak Eslami ◽  
Afshin Jafarzadeh ◽  
Kasra Karvandian ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Substance Dependence ◽  
Foley Catheter ◽  
Adult Patients ◽  
Emergence Agitation ◽  
Never Married ◽  
Neurologic Disorders ◽  
Substance Dependent ◽  
History Of

Background: This study aims to define the incidence and risk factors of both emergence agitation and hypoactive emergence in adult patients and substance-dependent patients following general anesthesia to elaborate on the risk factors and precise management of them. Methods: The study recruited 1,136 adult patients who received elective surgeries under general anesthesia for this prospective observational study. Inadequate emergence was determined according to the Richmond Agitation-Sedation Scale (RASS). Emergence agitation was defined as a RASS ≥ +1 point, and hypoactive emergence was defined as a RASS ≤ –2 points. Subgroup analyses were then conducted on patients with substance dependence.Results: Inadequate emergence in the post-anesthesia care unit (PACU) occurred in 20.3% of patients, including 13.9% with emergence agitation and 6.4% with hypoactive emergence. Ninety-five patients had a history of substance dependence. Compared to divorced patients, never-married and presently married patients, who underwent gynecological and thoracic surgeries, had a lower risk of agitation. Neurologic disorders, intraoperative blood loss, intraoperative morphine, and PACU analgesic drug administration were associated with increased agitation risk. Hypertension and psychological disorders, intraoperative opioids, and PACU Foley catheter fixation were associated with increased hypoactive emergence risk. Substance-dependent patients had higher risk for agitation (21.1%, P = 0.019) and hypoactive emergence (10.5%, P = 0.044). Conclusions: Inadequate emergence in PACU following general anesthesia is a significant problem correlated with several perioperative factors. Patients with a history of substance dependence appear to be more at risk of inadequate emergence than the general population.

scholarly journals Risk Factors of Emergence Agitation in Adults Undergoing General Anesthesia for Nasal Surgery

2015 ◽  
Vol 8 (1) ◽  
pp. 46 ◽  
Author(s):  
Hyo-Jin Kim ◽  
Duk-Kyung Kim ◽  
Hyo-Yeol Kim ◽  
Jin-Kyoung Kim ◽  
Seung-Won Choi
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Emergence Agitation ◽  
Nasal Surgery

scholarly journals Incidence of Emergence Agitation in Pediatric Patient after General Anesthesia

2021 ◽  
Vol 55 (1) ◽  
pp. 25
Author(s):  
Lucky Andriyanto ◽  
Arie Utariani ◽  
Elizeus Hanindito ◽  
Kohar Hari Santoso Hari Santoso ◽  
Hamzah Hamzah ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Pediatric Patient ◽  
Pediatric Anesthesia ◽  
Routine Care ◽  
Preoperative Anxiety ◽  
Emergence Agitation ◽  
Spss Software ◽  
Associated Risk Factors ◽  
Dissociated State

Post anesthesia agitation is common problem in pediatric post anesthesia care unit. The incidences range from 10 to 80%. EA has been described as a dissociated state of consciousness in which the child is inconsolable, irritable, and uncooperative typically thrashing, crying, moaning or incoherent. This study was done to determine the incidence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. This descriptive and analytic study was performed on 105 pediatric patient aged 1-12 years that underwent general anesthesia for various elective diagnostic and surgeries at Dr. Soetomo Hospital between January and February 2016. The presence of emergence agitation was recorded using Pediatric Anesthesia Emergence Delirium (PAED) scale. The factors that linked with Emergence Agitation were recorded in a questionnaire. The data were analyzed using SPSS software with logistic regression. p - values less than 0.05 were considered as significant. Forty two (40%) children had Emergence Agitation. Preoperative anxiety (p = 0.006) and Pain (p=0.035) were associated with higher rates of post anesthetic emergence agitation. This study identified preoperative anxiety and pain as risk factors, which are associated with emergence agitation in children. To minimize the incidence of post anesthetic emergence agitation, these risk factors should be considered in the routine care by anesthetist.

scholarly journals Comparing the Effects of Dexmedetomidine versus Propofol on the Treatment of Emergence Agitation in Adults after General Anesthesia: study protocol for a randomized controlled trial (DP-TEA Trial)

2021 ◽  
Author(s):  
Zhaoyan Feng ◽  
Xiao Shi ◽  
Xue Yan ◽  
Yamin Zhu ◽  
Juan Gu ◽  
...  
Keyword(s):  
Single Dose ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Medication Administration ◽  
Adult Patients ◽  
Nausea And Vomiting ◽  
Emergence Agitation ◽  
Randomized Controlled

Abstract BackgroundEmergence agitation (EA) from general anesthesia is a common complication in the post anesthesia care unit (PACU). Once EA happens, there is still no guidelines established to recommend the medication administration in adults. Propofol is widely used in managing agitated patient in the PACU, but it is lack of analgesia and can suppress breathing transiently. Intraoperative infusion of dexmedetomidine is proved to have preventive effect on EA, but the treatment effect of dexmedetomidine on EA occurring in the PACU remains unknown. This study aims to compare the effects between dexmedetomidine and propofol on relieving emergence agitation in the PACU in adult patients after general anesthesia. MethodsIn this randomized, controlled, single-blinded clinical study, a total of 120 adult patients aged 18-65 years of both genders, with American Society of Anesthesiologists (ASA) classification I or II who develop emergence agitation in the PACU after general anesthesia will be included. Patients will be randomized at 1:1 ratio to two groups, receiving either a single dose of dexmedetomidine (0.7ug/kg) or propofol (0.5mg/kg). The primary outcome is the recurrence rate of EA assessed by the Riker Sedation-Agitation Scale (RSAS). The secondary outcomes are RSAS scores and vital signs before and after intervention, the consumption of sufentanil in the PACU, nausea and vomiting scores evaluated by a four-point postoperative nausea and vomiting (PONV) scale when leaving the PACU, duration in the PACU, adverse events (desaturation, severe bradycardia, shivering, dizziness, laryngospasm, severe coughing, reintubation) and recovering quality evaluated by the 40-item quality of recovery scale (Qo-R 40).DiscussionPrevious studies are almost about the efficacy of premedication on preventing EA, while medicine administration on treating EA is reported rarely. This study is designed to investigate whether a single dose of dexmedetomidine can relieve EA more efficiently and improve recovery quality of adult patients form general anesthesia more significantly comparing to propofol.Trial registrationClinicalTrials.gov ID: NCT04142840.Registered on October 26, 2019. https://clinicaltrials.gov/ct2/show/NCT04142840.

scholarly journals Comparing the effects of dexmedetomidine versus propofol on the treatment of emergence agitation in adult patients after general anesthesia: study protocol for a randomized, superiority, controlled trial (DP-TEA Trial)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhaoyan Feng ◽  
Xiao Shi ◽  
Xue Yan ◽  
Yamin Zhu ◽  
Juan Gu ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Routine Care ◽  
Adult Patients ◽  
Emergence Agitation ◽  
Link Type ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Controlled Clinical Study

Abstract Background Emergence agitation (EA) after general anesthesia is a common complication in the post-anesthesia care unit (PACU). Once EA occurs, there are still no guidelines established for the treatment in adults. Propofol is excessively used in managing agitated patients in the PACU, but it lacks analgesia and can result in apnea. Intraoperative infusion of dexmedetomidine has been proven to have a preventive effect on EA, but the treatment effect of dexmedetomidine on EA remains unknown. This study aims to compare the effects between dexmedetomidine and propofol on relieving EA in adult patients after general anesthesia in the PACU. Methods In this randomized, superiority, controlled clinical study, a total of 120 adult patients aged 18–65 years of both genders, with American Society of Anesthesiologists (ASA) classification I or II developing EA in the PACU after general anesthesia, will be enrolled. Patients will be randomized at a 1:1 ratio into two groups, receiving either a single dose of dexmedetomidine (0.7μg/kg) or propofol (0.5 mg/kg). The primary outcome is the proportion of patients having a recurrent EA within 15 min after intervention in the PACU. Discussion Previous studies have focused on premedication for preventing EA, while therapeutics for reliving EA have rarely been reported. To our knowledge, this study is the first randomized, superiority, controlled trial to compare a bolus of dexmedetomidine with the current routine care for this indication. Trial registration ClinicalTrials.govNCT04142840. Registered on October 26, 2019

scholarly journals Survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities

2021 ◽  
Author(s):  
Mona Shaghayegh Maes ◽  
Philipp Kanzow ◽  
Valentina Hrasky ◽  
Annette Wiegand
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
General Anesthesia ◽  
Physical Disability ◽  
Median Survival Time ◽  
Cox Regression ◽  
Physical Disabilities ◽  
Adult Patients ◽  
Cox Regression Analysis ◽  
Composite Restorations

Abstract Objectives This study aimed to assess the survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities. Materials and methods Survival of composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities was retrospectively analyzed. Failure was defined as the need for replacement of at least one surface of the original restoration or extraction of the tooth. Individual-, tooth-, and restoration-related factors were obtained from dental records. Five-year mean annual failure rate (mAFR) and median survival time were calculated (Kaplan-Meier statistics). The effect of potential risk factors on failure was tested using univariate log-rank tests and multivariate Cox-regression analysis (α = 5%). Results A total of 728 restorations in 101 patients were included in the analysis. The survival after 5 years amounted to 67.7% (5-year mAFR: 7.5%) and median survival time to 7.9 years. Results of the multivariate Cox-regression analysis revealed physical disability (HR: 50.932, p = 0.001) and combined intellectual/physical disability (HR: 3.145, p = 0.016) compared with intellectual disability only, presence of a removable partial denture (HR: 3.013, p < 0.001), and restorations in incisors (HR: 2.281, p = 0.013) or molars (HR: 1.693, p = 0.017) compared with premolars to increase the risk for failure. Conclusion Composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities showed a reasonable longevity as 67.7% survived at least 5 years. Clinical relevance Survival of composite restorations depends on risk factors that need to be considered when planning restorative treatment in patients with intellectual and/or physical disabilities. NCT04407520

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