Perianestetisk forebygging av pediatrisk emergence delirium: en litteraturstudie

Abstract

Background: Pediatric emergence delirium is a phenomenon that occurs relatively often as a result of general anesthesia or sedation. The negative complications resulting from pediatric delirium are well documented, but little is known about preventive measures in the perianesthetic phase. The aim of this study is to gather available literature and summarize evidence-based preventive measures that can be implemented in the perianesthetic phase. Method: A literature search has been carried out in the databases MEDLINE, Embase and CINAHL. Sources are gathered from published journals and have been quality-assessed. Knowledge gaps in the available literature and proposals for further research were identified. Results: 12 articles were included. Two types of evidence-based interventions have been identified: pharmacological and non-pharmacological. Pharmacological measures include the administration of the drugs: Dexmedetomidine, Fentanyl, Nalbuphine, Propofol, Sevoflurane or Desflurane. Non-pharmacological measures include the presence of caregivers during awakening, anxiety-relieving distraction during induction and regulation of nurses, doctors and parents' behavior until induction has been completed. Conclusion: A review of the available literature reveals several evidence-based measures that can be implemented by a nurse anesthetist during the perianesthetic process. The results highlight that the measures that have been researched are not unambiguous in their effect. Further research is needed to shed light on the prevalence-, risk factors- and consequences of pediatric emergence delirium and the effect of preventive measures.