Emergence Delirium (ED) in Children

Emergence delirium in children is a state of mental dissociation that occurs while recovering from anesthetic agents and manifests as disorientation, restlessness, irritability, screaming and involuntary activity. It usually evolves in the first half hour after awakening from anesthesia, often lasts up to 20 minutes and usually resolves on its own. Many factors have been suggested to play a potential role in the development of such an event. Post anesthesia agitation has been noted more often with the newer, less soluble, inhaled anesthetics, such as desflurane and sevoflurane, than with other volatile ones; however administration of other anesthetic agents can also cause this disturbing recovery phenomenon. Emergence delirium occurs more often in preschool children and seen frequently after head and neck surgeries like tonsillectomy, adenoidectomy, tongue tie release, strabismus surgery, nasal operations etc. Treatment is with pharmacological and environmental. Prevention may be the best treatment but no one medication is entirely effective.