Clin Exp Otorhinolaryngol.  2015 Mar;8(1):46-51. 10.3342/ceo.2015.8.1.46.

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

• Kim HJ
• Kim DK
• Kim HY
• Kim JK
• Choi SW

• KMID: 1973487
• DOI: http://doi.org/10.3342/ceo.2015.8.1.46

Abstract

OBJECTIVES
To identify the incidence and the risk factors of emergence agitation in adults undergoing general anesthesia for nasal surgery.
METHODS
We retrospectively examined 792 patients aged > or =18 years who underwent general anesthesia for elective nasal surgery between July 2012 and August 2013. Patients in the postanesthesia care unit with a Richmond Agitation Sedation Scale> or =+1 at any time were considered to have emergence agitation.
RESULTS
The overall incidence of emergence agitation is 22.2%. From multivariate regression analysis, the following six variables were found to be significantly associated with emergence agitation (P<0.05): younger age, recent smoking, sevoflurane anesthesia, postoperative pain on the numerical rating scale (NRS)> or =5, presence of a tracheal tube, and presence of a urinary catheter. Presence of a tracheal tube was the greatest risk factor, increasing the risk of developing emergence agitation by approximately fivefold (odds ratio, 5.448; 95% confidence interval, 2.973 to 9.982). Younger age was also a strong risk factor (odds ratio, 0.975 for each 1-year increase; 95% confidence interval, 0.964 to 0.987). Current smoking, sevoflurane anesthesia, postoperative pain of NRS> or =5, and the presence of a urinary catheter nearly doubled the risk of emergence agitation.
CONCLUSION
Emergence agitation following general anesthesia is a common complication in adult nasal surgery patients. To reduce the occurrence and consequences of agitation episodes, elimination of the associated risk factors is necessary, especially in at-risk patients.

Keyword

Anesthesia Recovery Period; Nasal Surgical Procedures; Psychomotor Agitation

MeSH Terms

Adult*
Anesthesia
Anesthesia Recovery Period
Anesthesia, General*
Dihydroergotamine*
Humans
Incidence
Nasal Surgical Procedures*
Pain, Postoperative
Psychomotor Agitation
Retrospective Studies
Risk Factors*
Smoke
Smoking
Urinary Catheters
Dihydroergotamine
Smoke

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