A prospective, observational study to assess the incidence of Emergence Delirium inPediatric patients undergoing elective surgical procedures under General Anesthesia.

Emergence agitation (EA) has been defined as a dissociated state of consciousness in which the child is inconsolable, irritable, uncooperative, typically thrashing, crying, moaning or incoherent. The average estimated incidence of emergence delirium is between 18-30%. The risk factors involvedin emergence delirium include anaesthetic factors such as the type of  the agent used, presence of post operativepain and time taken for emergence from anaesthesia. Patient factors such as their age, period of preoperative fasting,presence of anxiety and parental anxiety also contribute to emergence deliriumalong with the type of surgical procedure being performed. Although the term emergence agitation has been limited to the post operative period, study done by Levy et al has shown that these children exhibit behavioural changes well beyond the recovery period  from general anaesthesia. As stated above in the definition of emergence delirium, includes any such behaviour as thrashing, uncooperative behaviour which can put the patient and healthcare provider at a risk of injury. Any injury to the patient at the surgical site doubles the duration of hospital stay and cost involved in their treatment.

The studies done previously have shown that inhalational agents such as halothane, isoflurane, desflurane  and sevoflurane have contributed to emergence delirium. However sevoflurane has been found to been the greatest contributor of emergence delirium in children . Hence we undertake this study to   further decipher the incidence of emergence delirium in our population using sevoflurane followed by isoflurane.