Severe Obesity and Sleep-Disordered Breathing as Risk Factors for Emergence Agitation in Pediatric Ambulatory Surgery.
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira and 2 others
PMID 29784260WHAT IT FOUND
Emergence agitation in children after outpatient surgery was associated with sleep-disordered breathing, severe obesity, and higher first pain scores.
PACU nurses can use these factors to plan safe monitoring.
Key findings
01Emergence agitation was documented in 66 of 1076 children.
02Children with sleep-disordered breathing had higher unadjusted rates of emergence agitation (8.5% vs 4.5%; OR 1.98).
03Severe obesity was the strongest adjusted predictor, with three-fold higher odds of emergence agitation (OR 3.38).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of prospectively collected data, so detailed agitation phenotype data were unavailable. Emergence agitation was recorded only as yes or no, so severity or grade could not be compared. Sleep-disordered breathing was diagnosed clinically without sleep study data, and combined symptoms allow misclassification. Oxygen saturation at the time of agitation was not recorded, so hypoxia-related restlessness cannot be excluded. Pain and emergence agitation are difficult to separate, and nurses often treated pain before labelling agitation. Anesthetic and perioperative care were not controlled, and the observational design leaves room for unmeasured confounders.
The easy way to misread this
Do not read these associations as proof that severe obesity or sleep-disordered breathing causes emergence agitation. This was an observational study, and agitation was recorded only as yes or no without severity, oxygen levels, or controlled anesthetic care.