Assessment of Magnitude and Associated Factors of Emergence Delirium in the Post Anesthesia Care Unit at Tikur Anbesa Specialized Hospital, Ethiopia

Abstract

BACKGROUND: Emergence delirium (ED) is known as an acute agitation and confusion occurring during or immediately following emergence from general anesthesia, in the Operation Room or post anesthesia care unit (PACU). ED results in significant morbidity and complications resulting in longer hospital stays. We studied the magnitude and risk factors of ED in the general surgical population.
METHODS: An institution-based prospective cross-sectional study was conducted on patients who underwent surgical procedure at Tikur Anbessa Specialized Hospital, Ethiopia, from March 6 - May 1, 2017. Data was collected using patient interview and chart review. Patients with Richmond Agitation Sedation Scale ≥+1 at any time were considered to have emergence delirium/agitation. Categorical data was analyzed using the fishers exact test . Continuous data was analyzed using student t-test. Independent variables were analyzed using binary logistic regression. P-value of <0.05 was considered as cutoff point to test for statistically significance.
RESULT: The overall magnitude of Emergence Delirium in this study was 31.7%. Older age (CI=4.266 – 12.095, P=0.001), substance abuse (OR =4.6, CI=1.962 – 10.863, P=0.001), preoperative anxiety (OR= 2.4, CI=1.140 – 5.244, P=0.02), benzodiazepine premedication (OR= 8, CI=2.788 – 23.21,P=0.001), excessive blood loss (OR=3.38, CI=1.789 – 6.412, P=0.001), postoperative pain (OR=3.37, CI=2.015 – 6.934, P=0.001) and longer PACU stay (CI=18.645 – 26.766, P=0.001) were positively associated with Emergence Delirium.
CONCLUSION: The magnitude of emergence delirium is high and it is associated with older age, substance abuse, premedication with benzodiazepine, excessive blood loss postoperative pain and longer PACU stay.