Emergence delirium in children undergoing dental surgery under general anaesthesia
Date
2018
Authors
Jooma, Zainub
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Abstract
Background: Emergence delirium (ED) is a well described complication in paediatric
anaesthesia, occurring more often in short surgical procedures using volatile anaesthetics
with a rapid recovery profile. Dental surgery is often performed under general anaesthesia in
children who would not tolerate dental chair procedures, those with special needs or
requiring extensive dentistry. The occurrence of ED in these children at a regional academic
hospital was not known.
Aim: The purpose of this study was to describe the occurrence of ED and the associated risk
factors in children undergoing elective dental surgery at Rahima Moosa Mother and Child
Hospital.
Methods: A prospective, descriptive study of healthy children aged two to six years
undergoing elective dental surgery under general anaesthesia was undertaken. Patients
were anaesthetised using standardised research protocols. Assessments included:
demographics of the child and caregiver, child anxiety at induction using the modified Yale
Preoperative Anxiety Scale, intraoperative events and Paediatric Anaesthesia Emergence
Delirium score in the recovery room. Data were assessed for associations and correlations.
Results: Ninety-one children with a mean age of 43.4 (SD=10.4) months were included in
the study. Anxiety was present in 69.2% at induction and ED was found in 51.6% of the
patients. Children with ED required an increased number of interventions in the recovery
room (p<0.0001). No association was found with age, gender, education level of the
caregiver, number of dental interventions, duration of anaesthesia, intubation status in the
recovery room and time to discharge. Correlations between ED and anxiety, age and
duration of anaesthesia were not significant.
Conclusions: ED occurs commonly after general anaesthesia for dental surgery but no
associated risk factors could be identified. The majority of the children presenting for dental
surgery are anxious. Children with ED require more interventions in the recovery room but
few require pharmacological treatment.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the
Degree of Master of Medicine in the branch of Anaesthesiology.
Johannesburg, 2017.
Keywords
Dental Surgery