Preoperative anxiety management, emergence delirium, and postoperative behavior

Anesthesiol Clin. 2014 Mar;32(1):1-23. doi: 10.1016/j.anclin.2013.10.011.

Abstract

Preoperative anxiolysis is important for children scheduled for surgery. The nature of the anxiety depends on several factors, including age, temperament, past hospitalizations, and socioeconomic and ethnic backgrounds. A panoply of interventions effect anxiolysis, including parental presence, distraction, and premedication, although no single strategy is effective for all ages. Emergence delirium (ED) occurs after the use of sevoflurane and desflurane in preschool-aged children in the recovery room. Symptoms usually last approximately 15 minutes and resolve spontaneously. The Pediatric Anesthesia Emergence Delirium scale is used to diagnose ED and evaluate therapeutic interventions for ED such as propofol and opioids.

Keywords: Anxiety; Children; Distraction; Emergence delirium; Parental presence; Pediatric; Premedication.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Anesthesia
  • Anesthesia Recovery Period*
  • Anti-Anxiety Agents / therapeutic use
  • Anxiety / drug therapy*
  • Anxiety / psychology
  • Behavior / drug effects*
  • Child
  • Child, Preschool
  • Delirium / psychology*
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Infant
  • Male
  • Postoperative Period*
  • Preoperative Care / methods*
  • Preoperative Period
  • Psychomotor Agitation / psychology
  • Sex Factors

Substances

  • Anti-Anxiety Agents
  • Hypnotics and Sedatives