A retrospective study on the risk factors for emergence agitation following general anesthesia

Yuka Honda, Shigeru Maeda, Hitoshi Higuchi, Yumiko Tomoyasu, Minako Ishii, Tomoko Hayashi, Kazuo Mukae, Ayaka Yamane, Akiko Kawase, Takuya Miyawaki

Research output: Contribution to journalArticle

Abstract

We performed a retrospective study on the risk factors for emergence agitation following general anesthesia in patients undergoing oral surgery in Okayama University Hospital between June 2011 and March 2012. This study was performed after approval by the Ethics Committee of the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. One hundred and eighty one patients aged more than 16 years old were enrolled. We used the Richmond Agitation and Sedation Scale (RASS, Table 1), which was developed to assess the level of agitation and sedation following general anesthesia The patients were divided into two groups : non-agitated patients (RASS score : -5 to 0) and agitated patients (RASS score : 1 to 4). The results were statistically analyzed using JMP 9.0.0 (SAS Institute, Cary, USA). In the univariate analysis, Fisher's exact test and the χ2 test were used to compare groups. A multivariable analysis was performed using stepwise logistic regression to separately determine risk factors of agitation. Of the 181 patients, emergence agitation occurred in 30 patients (16.6%). Agitation of level 1, 2, 3 or 4 of excitement according to the RASS was observed in 25, 4, 1, and 0 patients, respectively. Table 2 shows the risk factors of emergence agitation using univariate analysis. Emergence agitation was not correlated with age, BMI, duration of operation, postoperative pain, amount of opioid during the operation, or kind of postoperative analgesics, but was more common in males than females (p = 0.039) and also in patients who received general anesthesia than patients who received total intravenous anesthesia (p = 0.011). Table 3 shows the risk factors of emergence agitation using multivariate analysis by stepwise logistic regression. One variable was associated with emergence agitation. Inhalational anesthesia was the highest risk factor (odds ratio [OR] = 3.24; 95% confidence interval [CI] = 1.23-10.17 ; p = 0.015). In conclusion, the results suggest that inhalational anesthesia was the highest risk factor of emergence agitation.

Original languageEnglish
Pages (from-to)21-25
Number of pages5
JournalJournal of Japanese Dental Society of Anesthesiology
Volume41
Issue number1
Publication statusPublished - 2013

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General Anesthesia
Retrospective Studies
Anesthesia
Logistic Models
Emergence Delirium
School Dentistry
Intravenous Anesthesia
Ethics Committees
Oral Surgery
Postoperative Pain
Opioid Analgesics
Analgesics
Multivariate Analysis
Odds Ratio
Medicine
Confidence Intervals
Pharmaceutical Preparations

Keywords

  • Adults
  • Emergence agitation
  • General anesthesia
  • Inhalational anesthetics
  • Oral surgery

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Dentistry(all)

Cite this

A retrospective study on the risk factors for emergence agitation following general anesthesia. / Honda, Yuka; Maeda, Shigeru; Higuchi, Hitoshi; Tomoyasu, Yumiko; Ishii, Minako; Hayashi, Tomoko; Mukae, Kazuo; Yamane, Ayaka; Kawase, Akiko; Miyawaki, Takuya.

In: Journal of Japanese Dental Society of Anesthesiology, Vol. 41, No. 1, 2013, p. 21-25.

Research output: Contribution to journalArticle

Honda, Yuka ; Maeda, Shigeru ; Higuchi, Hitoshi ; Tomoyasu, Yumiko ; Ishii, Minako ; Hayashi, Tomoko ; Mukae, Kazuo ; Yamane, Ayaka ; Kawase, Akiko ; Miyawaki, Takuya. / A retrospective study on the risk factors for emergence agitation following general anesthesia. In: Journal of Japanese Dental Society of Anesthesiology. 2013 ; Vol. 41, No. 1. pp. 21-25.
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abstract = "We performed a retrospective study on the risk factors for emergence agitation following general anesthesia in patients undergoing oral surgery in Okayama University Hospital between June 2011 and March 2012. This study was performed after approval by the Ethics Committee of the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. One hundred and eighty one patients aged more than 16 years old were enrolled. We used the Richmond Agitation and Sedation Scale (RASS, Table 1), which was developed to assess the level of agitation and sedation following general anesthesia The patients were divided into two groups : non-agitated patients (RASS score : -5 to 0) and agitated patients (RASS score : 1 to 4). The results were statistically analyzed using JMP 9.0.0 (SAS Institute, Cary, USA). In the univariate analysis, Fisher's exact test and the χ2 test were used to compare groups. A multivariable analysis was performed using stepwise logistic regression to separately determine risk factors of agitation. Of the 181 patients, emergence agitation occurred in 30 patients (16.6{\%}). Agitation of level 1, 2, 3 or 4 of excitement according to the RASS was observed in 25, 4, 1, and 0 patients, respectively. Table 2 shows the risk factors of emergence agitation using univariate analysis. Emergence agitation was not correlated with age, BMI, duration of operation, postoperative pain, amount of opioid during the operation, or kind of postoperative analgesics, but was more common in males than females (p = 0.039) and also in patients who received general anesthesia than patients who received total intravenous anesthesia (p = 0.011). Table 3 shows the risk factors of emergence agitation using multivariate analysis by stepwise logistic regression. One variable was associated with emergence agitation. Inhalational anesthesia was the highest risk factor (odds ratio [OR] = 3.24; 95{\%} confidence interval [CI] = 1.23-10.17 ; p = 0.015). In conclusion, the results suggest that inhalational anesthesia was the highest risk factor of emergence agitation.",
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