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 acuteagitation and confusion occurring during or immediately followingemergence from general anesthesia, in the Operation Room or postanesthesia care unit (PACU). ED results in significant morbidityand complications resulting in longer hospital stays. We studied themagnitude and risk factors of ED in the general surgicalpopulation.METHODS: An institution-based prospective cross-sectional studywas conducted on patients who underwent surgical procedure atTikur Anbessa Specialized Hospital, Ethiopia, from March 6 - May1, 2017. Data was collected using patient interview and chartreview. Patients with Richmond Agitation Sedation Scale ≥+1 atany 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. Independentvariables were analyzed using binary logistic regression. P-value of<0.05 was considered as cutoff point to test for statisticallysignificance.RESULT: The overall magnitude of Emergence Delirium in thisstudy 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 andit is associated with older age, substance abuse, premedication withbenzodiazepine, excessive blood loss postoperative pain and longerPACU stay.