Case Scenario: Severe Emergence Agitation after Myringotomy in a 3-yr-old Child

Souhayl Dahmani, Jean Mantz, Francis Veyckemans

Anesthesiology, V 117, No 2 - August 2012

Emergence agitation (EA) in children, also called postanesthetic or postoperative delirium, agitation, or excitement in children, is a specific pediatric postoperative complication. Its reported incidence ranges from 2 to 80%.1,2 This explains in part why it is usually considered as a part of the “normal” emergence process by many pediatric anesthesiologists. However, for those who episodically care for pediatric patients in the postanesthesia period (both medical and nursing staff), it may represent a significant source of anxiety and disappointment. Moreover, parents of children experiencing this complication might be terrorized by this event, and the motor agitation accompanying EA may cause harm to the child, such as loss of IV line, removal of surgical dressing, and so on.

In the current case scenario, we shall focus on the description of emergence agitation and the associated risk factors, prevention, and treatment. We will also try to establish a relation between EA and other postoperative behavioral issues observed in children, such as postoperative maladaptive behaviors.

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