Preschool children who experience ’emergence delirium’ post-surgery do not have long-term effects

Emergence delirium—a confused state during recovery from anesthesia that may include disorientation, hallucination, restlessness and purposeless hyperactivity—does not affect a child’s behavior three months after surgery, according to research being presented at the Anesthesiology 2022 annual meeting.

“Sitting in the waiting room while your child has surgery is always a distressing time for parents and it’s even more upsetting watching your child come out of anesthesia displaying unusual behavior such as inconsolability, unresponsiveness, restlessness or incoherence,” said Amira Joseph, M.D., lead author of the study and anesthesiology resident, Mayo Clinic College of Medicine, Rochester, Minnesota. “We wanted to see if there was an association between those children who exhibited emergence delirium, a common issue experienced by young children after surgery, and behavioral changes three months out.”

Sixty-eight preschool children aged 2.5 to 6 years old were enrolled in the study between September 2018 and February 2021. Behavior was measured using the Behavior Assessment System for Children on two occasions—preoperatively (from a week to one day before anesthesia) and three months postoperatively. Ear, nose and throat procedures were most commonly performed. The median anesthesia duration was 75 minutes. Thirty-five percent of the children experienced emergence delirium.

The study found that regardless of emergence delirium, there were no measurable behavioral problems at three months postoperatively.

“It was previously unknown if emergence delirium affects children’s behavior in the longer term,” said Dr. Joseph. “Our study provides reassurance to health care providers and parents of children who need surgery that there won’t be behavioral issues long-term from having general anesthesia administered.”