Emergence Agitation or Excited Delirium?
Abstract
During emergence from general anesthesia some patients are inconsolable, restless, and/or agitated. This complication may arise by variety of physiological and pharmacological factors during awakening from anesthesia. Excited delirium is a state of extreme mental and physiological excitement characterized by extreme agitation. We report a 15-year-old male patient with cannabis abuse, who was in emergence agitation or excited delirium after gastro-endoscopic procedure with propofol and ketamine sedation. In this case midazolam was not adequate and haloperidol was administered in order to diminish severe agitation. Emergence agitation may be related with cannabis abuse, and haloperidol may be the correct choice for treatment.
References
Moore AD, Anghelescu DL. EmergenceDelirium in PediatricAnesthesia. PaediatrDrugs 2017; 19:11-20.
Kanaya A. Emergenceagitation in children: risk factors, prevention, andtreatment. J Anesth. 2016;30:261-7.
Gololobov A, Todris L, Berman Y, Rosenberg-Gilad Z, Schlaeffer P, Kenett R, et al. Pediatricanesthesia emergencedelirium afterelectiveambulatorysurgery: etiology, risk factorsandprevalence. Harefuah. 2015;154:236-9, 280.
Nguyen HTA. Cannabis (Marijuana) and Anesthesia. Anesthesiology Rounds. 2004; 3:9.
Amr MA, Shams T, Al-Wadani H.Does haloperidol prophylaxis reduce ketamine-induced emergence delirium in children?Sultan QaboosUniv Med J. 2013;13:256-62.
