Anesth Pain Med.  2016 Oct;11(4):410-416. 10.17085/apm.2016.11.4.410.

Risk factors of emergence agitation after general anesthesia in adult patients

• Rim JC
• Kim JA
• Hong JI
• Park SY
• Lee JH
• Chung CJ

• KMID: 2358341
• DOI: http://doi.org/10.17085/apm.2016.11.4.410

Abstract

BACKGROUND
Emergence agitation (EA) is one of the most common complications after general anesthesia. The goal of this retrospective study was to determine the risk factors of EA in adult patients who underwent general anesthesia.
METHODS
We retrospectively investigated the medical records of 5,358 adult patients who stayed in the postanesthesia care unit (PACU) of our hospital after general anesthesia during the 1-year period from January 2014 to December 2014. Psychological and behavioral status in the PACU was determined by the Aono four-point scale. Grade of 3 or 4 were considered as manifestations of EA. Multiple variables assessed EA risk factors.
RESULTS
Two-hundred-forty-five patients (4.6%) developed EA. In multivariate analysis, male gender (OR = 1.626, P = 0.001), older age (OR = 1.010, P = 0.035), abdominal surgery (OR = 1.633, P = 0.002), spine surgery (OR = 1.777, P = 0.015), longer duration of anesthesia (OR = 1.002, P < 0.001), postoperative nausea and vomiting (OR = 20.164, P < 0.001) and postoperative pain (OR = 3.614, P < 0.001) were risk factors of EA.
CONCLUSIONS
Male gender and older patients were risk factors of EA after general anesthesia in adult patients. Careful attention is needed for patients who receive abdominal or spine surgery, and who receive prolonged anesthesia. Adequate postoperative analgesia and antiemetic therapy should be provided to reduce the incidence of EA.

Keyword

Anesthesia recovery period; Delirium; General anesthesia

MeSH Terms

Adult*
Analgesia
Anesthesia
Anesthesia Recovery Period
Anesthesia, General*
Delirium
Dihydroergotamine*
Humans
Incidence
Male
Medical Records
Multivariate Analysis
Pain, Postoperative
Postoperative Nausea and Vomiting
Retrospective Studies
Risk Factors*
Spine
Dihydroergotamine

Figure

• 

  Fig. 1 Flowchart of study population.

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