Incidence and Risk Factors of Emergence Delirium after
General and Regional Anesthesia in Elective Non-Cardiac
Surgery Patients
Sithapan Munjupong MD1, Tippaporn Sripon MD1, Sutira Siripoonyothai MD1, Narongsak Jesadapatarakul MD1,
Teerawat Poojinya MD1, Nopadon Chernsirikasem MD1
Affiliation :
1 Department of Anesthesiology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Objective : To evaluate the incidence and risk factors of emergence delirium (ED) after general and regional anesthesia in elective
non-cardiac surgery.
Materials and Methods : A prospective observational study was conducted among 454 patients aged over 18 years. The incidence
of ED was assessed. Perioperative and intraoperative factors were also assessed using the Richmond Agitation-Sedation Scale
(RASS) and the Confusion Assessment Method (CAM) Thai version. Univariable analysis was performed followed by multivariable
logistic regression.
Results : Sixty-(cid:976)ive (14.32%) patients developed ED, of whom 9.25% presented hypoactive delirium and 5.07% presented
hyperactive delirium. In multivariable analysis, patients older than 60 years [p=0.003; adjusted odds ratio (adjusted OR) 2.50],
having underlying chronic kidney disease (p=0.016; adjusted OR 2.56), and anesthetic induction with etomidate (p=0.017; adjusted
OR 9.60), cisatracurium (p=0.006; adjusted OR 0.35), sevo(cid:976)lurane (p=0.003; adjusted OR 2.52), and postoperative pain score ≤3
(p=0.010; adjusted OR 3.63) were signi(cid:976)icantly more likely to experience ED.
Conclusion : Patients aged more than 60 years, with underlying chronic kidney disease, mild pain score, and anesthetized with
etomidate, cisatracurium, and sevo(cid:976)lurane had increased risk factors for ED. Therefore, to treat underlying disease and anesthetic
medication, health providers should have essential knowledge to minimize the incidence of ED.
Keywords : Complication, Delirium, General anesthesia, Regional anesthesia, Recovery, Postoperative surgery
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