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Abstract：
BACKGROUND: Emergence agitation is a transient confusional state of a child associated with consciousness from general anaesthesia, commonly occurs in the postoperative setting which delays their recovery and exposes them to traumas. The main objective of the current study was to investigate the magnitude of emergence agitation, its interventions and associated factors among paediatric surgical patients at Saint Paul\'s Hospital Millennium Medical College, Addis Ababa, Ethiopia.
METHODS: Hospital based cross-sectional study with prospective follow-up framework was conducted on a paediatric surgical patients aged 2-14 years who underwent surgery under general anaesthesia between June 1 - October 30 2022. Stratified sampling method followed by simple random sampling technique was employed to reach study participants. Magnitude of emergence agitation and its interventions done at post-anaesthetic care units were recorded. Data analysis was carried out using a descriptive statistics method and the results were summarized using tables and diagrams. Bivariate analysis was done to identify causal relationship and multivariable analysis to assess the confounding effects of factors associated with emergence agitation. A p-value of less than 0.05 was considered statistically significant factor.
RESULTS: A total of 150 participants were included in the current study, where 107 (71.3%) were male and 97 (64.7%) were preschool aged. About 81 (54%) of care givers were female and majority of them have completed primary school. The mean (standard deviation) age of the participants was 6.4 (3.57) years. Around 42.7% of them developed emergence agitation with an average duration of 8.39 ± 4.45 minutes. Factors such as propofol administration at the end of procedure (OR of 0.104 with 95% CI [0.035, 0305]), Ear, nose, throat surgery and oral maxillofacial surgery (OR of 2.341 with 95% CI [1.051, 5.211]) and arrival of patient to recovery awake (OR of 0.456 95% CI [0.209, 0.994]) showed statistically significant association with emergence agitation.
CONCLUSIONS: Almost half of the study participants experienced emergence agitation which is high magnitude. Ear, nose, throat surgery and oral maxillofacial surgeries were predictive factors of emergence agitation while propofol administration at the end of procedure and arrival of patient to recovery awake significantly decreased risk of emergence agitation. Therefore, anaesthesia personnel should have essential skills and knowledge to effectively care for children perioperatively including to minimize and treat emergence agitation.
METHODS: Hospital based cross-sectional study with prospective follow-up framework was conducted on a paediatric surgical patients aged 2-14 years who underwent surgery under general anaesthesia between June 1 - October 30 2022. Stratified sampling method followed by simple random sampling technique was employed to reach study participants. Magnitude of emergence agitation and its interventions done at post-anaesthetic care units were recorded. Data analysis was carried out using a descriptive statistics method and the results were summarized using tables and diagrams. Bivariate analysis was done to identify causal relationship and multivariable analysis to assess the confounding effects of factors associated with emergence agitation. A p-value of less than 0.05 was considered statistically significant factor.
RESULTS: A total of 150 participants were included in the current study, where 107 (71.3%) were male and 97 (64.7%) were preschool aged. About 81 (54%) of care givers were female and majority of them have completed primary school. The mean (standard deviation) age of the participants was 6.4 (3.57) years. Around 42.7% of them developed emergence agitation with an average duration of 8.39 ± 4.45 minutes. Factors such as propofol administration at the end of procedure (OR of 0.104 with 95% CI [0.035, 0305]), Ear, nose, throat surgery and oral maxillofacial surgery (OR of 2.341 with 95% CI [1.051, 5.211]) and arrival of patient to recovery awake (OR of 0.456 95% CI [0.209, 0.994]) showed statistically significant association with emergence agitation.
CONCLUSIONS: Almost half of the study participants experienced emergence agitation which is high magnitude. Ear, nose, throat surgery and oral maxillofacial surgeries were predictive factors of emergence agitation while propofol administration at the end of procedure and arrival of patient to recovery awake significantly decreased risk of emergence agitation. Therefore, anaesthesia personnel should have essential skills and knowledge to effectively care for children perioperatively including to minimize and treat emergence agitation.
摘要：
背景：苏醒躁动是与全身麻醉意识相关的儿童的一种短暂的混乱状态，通常发生在术后情况下，这会延迟他们的康复并使他们遭受创伤。当前研究的主要目的是调查出现躁动的程度，圣保罗医院千年医学院儿科手术患者的干预措施及相关因素，亚的斯亚贝巴,埃塞俄比亚。
方法：对2022年6月1日至10月30日期间在全身麻醉下接受手术的2-14岁儿科手术患者进行了前瞻性随访框架的基于医院的横断面研究。采用分层抽样方法，然后采用简单的随机抽样技术来接触研究参与者。记录了麻醉后护理单位的出现躁动程度及其干预措施。使用描述性统计方法进行数据分析，并使用表格和图表总结结果。进行双变量分析以确定因果关系，并进行多变量分析以评估与出现躁动相关的因素的混杂效应。小于0.05的P值被认为是统计学上显著的因素。
结果：本研究共纳入150名参与者，其中107（71.3％）为男性，97（64.7％）为学龄前。大约81名（54％）的护理人员是女性，其中大多数已经完成了小学教育。参与者的平均（标准差）年龄为6.4（3.57）岁。其中约有42.7％的人出现了出现搅动，平均持续时间为8.39±4.45分钟。手术结束时丙泊酚给药等因素（OR为0.104，95%CI[0.035,0305]），耳朵,鼻子,咽喉手术和口腔颌面手术(OR为2.341,95%CI[1.051,5.211])和患者到达清醒状态(OR为0.45695%CI[0.209,0.994])与苏醒期躁动有统计学意义的关联.
结论：几乎一半的研究参与者经历了高幅度的出现躁动。耳朵,鼻子,咽喉手术和口腔颌面手术是苏醒期躁动的预测因素,而在手术结束和患者苏醒后给予异丙酚可显著降低苏醒期躁动的风险.因此,麻醉人员应具备必要的技能和知识，以围手术期有效地照顾儿童，包括减少和治疗出现的躁动。
方法：对2022年6月1日至10月30日期间在全身麻醉下接受手术的2-14岁儿科手术患者进行了前瞻性随访框架的基于医院的横断面研究。采用分层抽样方法，然后采用简单的随机抽样技术来接触研究参与者。记录了麻醉后护理单位的出现躁动程度及其干预措施。使用描述性统计方法进行数据分析，并使用表格和图表总结结果。进行双变量分析以确定因果关系，并进行多变量分析以评估与出现躁动相关的因素的混杂效应。小于0.05的P值被认为是统计学上显著的因素。
结果：本研究共纳入150名参与者，其中107（71.3％）为男性，97（64.7％）为学龄前。大约81名（54％）的护理人员是女性，其中大多数已经完成了小学教育。参与者的平均（标准差）年龄为6.4（3.57）岁。其中约有42.7％的人出现了出现搅动，平均持续时间为8.39±4.45分钟。手术结束时丙泊酚给药等因素（OR为0.104，95%CI[0.035,0305]），耳朵,鼻子,咽喉手术和口腔颌面手术(OR为2.341,95%CI[1.051,5.211])和患者到达清醒状态(OR为0.45695%CI[0.209,0.994])与苏醒期躁动有统计学意义的关联.
结论：几乎一半的研究参与者经历了高幅度的出现躁动。耳朵,鼻子,咽喉手术和口腔颌面手术是苏醒期躁动的预测因素,而在手术结束和患者苏醒后给予异丙酚可显著降低苏醒期躁动的风险.因此,麻醉人员应具备必要的技能和知识，以围手术期有效地照顾儿童，包括减少和治疗出现的躁动。
