Pencegahan Emergence Agitation Pasca-operasi pada Pasien Anak
DOI:
https://doi.org/10.55175/cdk.v47i1.6Kata Kunci:
Anak, anestesi, delirium, emergence agitation, Anesthesia, pediatricAbstrak
Emergence agitation (EA) adalah gangguan perilaku pasca-operasi terkait pemulihan anestesi yang sering dijumpai pada pasien anak usia prasekolah. Meskipun hanya sementara, EA tetap berpotensi membahayakan pasien, menambah biaya perawatan, dan ketidakpuasan orang tua pasien. Etiologi pasti belum jelas diketahui, diduga multifaktorial. Diagnosis EA dengan skala Pediatric Anesthesia Emergence Delirium (PAED). Manajemen anestesi yang baik melalui intervensi non-farmakologis dan farmakologis yang tepat dapat mencegah EA.
Emergence agitation (EA) is an anesthetic recovery-related postoperative negative behaviour, usually in preschool pediatric patients. Although temporary and self-limited, it may increase the risk of self-harm, medical care costs and decrease parent’s satisfaction. The exact cause and underlying mechanism are yet to be determined but several factors may be involved. Diagnosis is by Pediatric Anesthesia Emergence Delirium (PAED) scale. Proper anesthetic management implementing non-pharmacological and pharmacological interventions may prevent EA.
Unduhan
Referensi
Van Hoff SL, O’Neill ES, Cohen LC, Collins BA. Does a prophylactic dose of propofol reduce emergence agitation in children receiving anesthesia? A systematic review and meta-analysis. Paediatr Anesth. 2015;25:668-76.
Costi D, Ellwood J, Wallace A, Ahmed S, Waring L, Cyna A. Transition to propofol after sevoflurane anesthesia to prevent emergence agitation: A randomized controlled trial. Paediatr Anesth. 2015;25:517-23.
Jiang S, Liu J, Li M, Ji W, Liang J. The efficacy of propofol on emergence agitation – a meta-analysis of randomized controlled trials. Acta Anaesthesiol Scand. 2015;59:1232-45.
Aouad MT, Yazbeck-Karam VG, Nasr VG, El-Khatib MF, Kanazi GE, Bleik JH. A single dose of propofol at the end of surgery for the prevention of emergence agitation in children undergoing strabismus surgery during sevoflurane anesthesia. Anesthesiology 2007;107:733-8.
Nicholau D, Haehn M. Postanesthesia recovery. In: Pardo Jr. MC, Miller RD, editors. Basics of Anesthesia 7th ed. Philadelphia: Elsevier; 2018 .p. 675-86.
Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C, et al. Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: A meta-analysis of published studies. Br J Anaesth. 2010;104:216-23.
Frawley G, Davidson A. Inhaled anesthetic agents. In: Davis PJ, Cladis FP, editors. Smith’s anesthesia for infants and children 9th ed. Philadelphia: Elsevier; 2017 .p. 211.
Huett C, Baehner T, Erdfelder F, Hoehne C, Bode C, Hoeft A, et al. Prevention and therapy of pediatric emergence delirium: A national survey. Paediatr Drugs 2017;19:147-53.
Kanaya A, Kuratani N, Satoh D, Kurosawa S. Lower incidence of emergence agitation in children after propofol anesthesia compared with sevoflurane: A metaanalysis of randomized controlled trials. J Anesth. 2014;28:4-11.
Moore AD, Anghelescu DL. Emergence delirium in pediatric anesthesia. Pediatr Drugs 2017;19:11-20.
Kanaya A. Emergence agitation in children: Risk factors, prevention, and treatment. J Anesth. 2016;30:261-7.
Da Silva LM, Braz LG, Modolo NSP. Emergence agitation in pediatric anesthesia: Current features. J Pediatr (Rio J) 2008;84:107-13.
Smith HAB, Fuchs DC, Pandharipande PP, Barr FE, Ely EW. Delirium: An emerging frontier in the management of critically ill children. Anesthesiol Clin. 2011;29:729-50.
Maldonado JR. Neuropathogenesis of delirium: Review of current etiologic theories and common pathways. Am J Geriatr Psychiatr. 2013;21:1190-222.
Shung J. The agitated child in recovery. South Afr J Anaesth Analg. 2011;17:96-9.
Nasr VG, Hannallah RS. Emergence agitation in children: A review. Middle East J Anesthesiol 2011;21:175-84.
Aono J, Mamiya K, Manabe M. Preoperative anxiety is associated with a high incidence of problematic behavior on emergence after halothane anesthesia in boys. Acta Anaesthesiol Scand. 1999;43:542-4.
Burke CN, Voepel-Lewis T, Hadden S, DeGrandis M, Skotcher S, D’Agostino R, et al. Parental presence on emergence: Effect on postanesthesia agitation and parent satisfaction. J Perianesth Nurs. 2009;24:216-21.
Somaini M, Ingelmo PM. Negative behaviour after surgery. In: Astuto M, Ingelmo PM, editors. Perioperative medicine in pediatric anesthesia. Switzerland: Springer Internat Publ.; 2016 .p. 408-10.
Liu GY, Chen ZQ, Zhang ZW. Comparative study of emergence agitation between isoflurane and propofol anesthesia in adults after closed reduction of distal radius fracture. Genet Mol Res. 2014;13:9285-91.
Singh R, Kharbanda M, Sood N, Mahajan V, Chatterji C. Comparative evaluation of incidence of emergence agitation and post-operative recovery profile in paediatric patients after isoflurane, sevoflurane and desflurane anesthesia. Indian J Anaesth. 2012; 56:156-61.
Voepel-Lewis T, Malviya S, Tait AR. A prospective cohort study of emergence agitation in the pediatric post anesthesia care unit. Anesth Analg. 2003;96:1625-30.
Key KL, Rich C, DeCristofaro C, Collins S. Use of propofol and emergence agitation in children: A literature review. AANA J 2010;78: 468-73.
Sikich N, Lerman J. Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale. Anesthesiology 2004;100:1138-45.
Lee CA. Paediatric emergence delirium: An approach to diagnosis and management in the postanaesthesia care unit. J Perioper Crit Intensive Care Nurs. 2017;3:140.
Ali MA, Abdellatif AA. Prevention of sevoflurane related emergence agitation in children undergoing adenotonsillectomy: A comparison of dexmedetomidine and propofol. Saudi J Anaesth. 2013;7:296-300.
Garg A, Kamal M, Mohammed S, Singariya G, Chouhan DS, Biyani G. Efficacy of dexmedetomidine for prevention of emergence agitation in patients posted for nasal surgery under desflurane anaesthesia: A prospective double-blinded randomised controlled trial. Indian J Anaesth. 2018;62:524-30.
Fang XZ, Gao J, Ge YL, Zhou LJ, Zhang Y. Network meta-analysis on the efficacy of dexmedetomidine, midazolam, ketamine, propofol, and fentanyl, for the prevention of sevoflurane-related emergence agitation in children. Am J Ther. 2016;23:1032-42.
Mason KP. Paediatric emergence delirium: A comprehensive review and interpretation of the literature. Br J Anaesth. 2017;118:335-43.
Lee YS, Kim WY, Choi JH, Son JH, Kim JH, Park YC. The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia. Korean J Anesthesiol. 2010;58:440-5.
Butterworth JF, Mackey DC, Wasnick JD, editors. Morgan & Mikhail’s clinical anesthesiology 5th ed. New York: McGraw-Hill; 2017 .p. 185-7.
Blasiole B, Davis PJ. Intravenous agents. In: Davis PJ, Cladis FP, editors. Smith’s anesthesia for infants and children 9th ed. Philadelphia: Elsevier; 2017 .p. 192-4.
Makkar JK, Bhatia N, Bala I, Dwivedi D, Singh PM. A comparison of single dose dexmedetomidine with propofol for the prevention of emergence delirium after desflurane anaesthesia in children. Anaesthesia 2016;71:50-7.
Kim MS, Moon BE, Kim H, Lee JR. Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children. Br J Anaesth. 2013;110:274-80.
Chidambaran V, Costandi A, D’Mello A. Propofol: A review of its role in pediatric anesthesia and sedation. CNS Drugs 2015;29(7):543-63.
Society for Pediatric Anesthesia. SPA newsletter. Society for Pediatric Anesthesia [Internet]. 2002 [2018 Mar 9]. Available from: http://www2.pedsanesthesia.org/
Unduhan
Diterbitkan
Cara Mengutip
Terbitan
Bagian
Lisensi
Hak Cipta (c) 2020 Cermin Dunia Kedokteran
Artikel ini berlisensi Creative Commons Attribution-NonCommercial 4.0 International License.