Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Original Investigation

The impact of emergence delirium on hospital length of stay for children who underwent tonsillectomy/adenotonsillectomy: an observational retrospective study

O impacto do delírio de emergência no tempo de internação de crianças submetidas a tonsilectomia/adenotonsilectomia: um estudo observacional retrospectivo

Alessandro Simonini, Alessandro Vittori, Marco Cascella, Maria Grazia Calevo, Franco Marinangeli

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Emergence Delirium (ED) is a combination of disturbance of perception and psychomotor agitation that is common in pediatric patients after general anesthesia, especially at preschool age. Since the effect of ED on the length of stay has been studied in adults but infrequently in children, the aim of this study was to investigate the relationship between ED and length of stay in this population.

A single center, retrospective, observational study was carried out in children who underwent tonsillectomy or adenotonsillectomy. The Pediatric Anesthesia Emergence Delirium (PAED) scale was used to assess ED. In addition to the time to hospital discharge (time frame 24 hours), drugs used, comorbidities, early postoperative complications, and pain were investigated if potentially associated with the complication.

Four hundred sixteen children aged from 1.5 to 10 years (183 female, 233 male) were included. ED occurred in 25.5% of patients (n = 106). Patients were divided into the ED group and the No-ED group. The discharge time was similar in both groups. No significant differences were observed in the frequency of postoperative complications. The use of fentanyl or dexmedetomidine did not affect ED occurrence. The frequency of pain was greater in the ED group, both in the recovery room and in the ward (p = 0.01).

The occurrence of ED in children after tonsillectomy/adenotonsillectomy did not extend the length of stay.


Children;  Emergence delirium;  Dexmedetomidine;  Length of stay;  Pain;  Anesthesia



O Delírio de Emergência (DE) é uma combinação de distúrbio da percepção e agitação psicomotora comum em pacientes pediátricos após anestesia geral, especialmente na idade pré-escolar. Como o efeito do DE no tempo de internação foi estudado em adultos, mas raramente em crianças, o objetivo deste estudo foi investigar a relação entre DE e tempo de internação nessa população.


Um estudo observacional retrospectivo de centro único foi realizado em crianças submetidas a tonsilectomia ou adenotonsilectomia. A escala Pediatric Anesthesia Emergence Delirium (PAED) foi usada para avaliar a DE. Além do tempo até a alta hospitalar (período de 24 horas), medicamentos em uso, comorbidades, complicações pós-operatórias precoces e dor foram investigados se potencialmente associados à complicação.


Quatrocentas e dezesseis crianças com idades entre 1,5 e 10 anos (183 do sexo feminino e 233 do sexo masculino) foram incluídas. DE ocorreu em 25,5% dos pacientes (n = 106). Os pacientes foram divididos em grupo DE e grupo sem DE. O tempo de alta foi semelhante em ambos os grupos. Não foram observadas diferenças significativas na frequência de complicações pós-operatórias. O uso de fentanil ou dexmedetomidina não afetou a ocorrência de DE. A frequência de dor foi maior no grupo DE, tanto na sala de recuperação quanto na enfermaria (p = 0,01).


A ocorrência de DE em crianças após tonsilectomia/adenotonsilectomia não prolongou o tempo de internação.


Crianças; Delírio de emergência; Dexmedetomidina; Tempo de permanência; Dor; Anestesia


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