Emergence delirium in children: a Brazilian survey

Pediatric emergence delirium is presented as a disturbance of consciousness and attention, with disorientation and perceptual alterations, including hypersensitivity to stimuli and hyperactive motor behaviors. Many studies evaluated risk factors and pharmacological regimens to prevent and treat emergence delirium. There have been two reports on the practice of anesthesiologists concerning diagnosis, prevention, and treatment of emergence delirium. We aimed to know the practice of the Brazilian anesthesiologist regarding the concept, risk factors, diagnosis and forms of prevention and treatment of emergence delirium in children. A REDCap® web-based survey was sent to all anesthesiologists associated with the Brazilian Society of Anesthesiology by SMS and e-mail. Considering a population of 24 thousand anesthesiologists in Brazil, a 95% confidence interval and a 5% margin of error, a sample size of 648 responders was required for this study. We obtained 671 responses. Of respondents, 92,8% consider emergence delirium as a relevant adverse event and 39,6% reported that emergence delirium interferes “too much” in the quality of anesthesia in their institution. High levels of childhood anxiety, using sevoflurane and previous history of emergence delirium were considered as risk factors for 79.6%, 79,2%, and 72.3%, respectively. More than 90% considered untreated postoperative pain as a risk factor too. More than half of respondents said they evaluate their patients regarding emergence delirium, but 95.1% did not routinely use a validated score tool. Sixty-seven percent reported not routinely using pharmacological strategies to prevent emergence delirium. Propofol and clonidine were the most common anesthetic given to prevent emergence delirium (15.7% and 15.4%, respectively). Midazolam, propofol, and dexmedetomidine were the most common medication given for treatment (25.6%, 34.5%, and 10.6%, respectively). These raw data were de-identified using REDCap® functionality. It is presented as an Excel CSV spreadsheet along with a data codebook translated into English and the original in Portuguese.