Discharge Under Sedated Status can Decrease Postoperative Emergence Agitation in Pediatric Patients Undergoing Strabismus Surgery: A Prospective Randomized Controlled Trial

Abstract

Purpose

Emergence agitation (EA) is a frequent complication during emergence. The researchers aimed to investigate whether discharged pediatric patients from the postanesthesia care unit (PACU) to wards under sedated status could reduce the incidence of EA.

Design

Prospective randomized controlled study.

Methods

This study was conducted in 4 to 6 year old patients who had undergone strabismus surgeries. There were 100 patients randomly assigned to a sedated group who were discharged from PACU to the ward under a sedated state and regained consciousness accompanied with their parents (Group P, n = 50) and the control group who were fully awake when discharged (Group C, n = 50). The primary outcome was the incidence of EA. The secondary outcomes included rescue measure, discharge time, hemodynamic parameters at the point of discharge, 1 and 2 hours after extubation, and the parental satisfaction score.

Findings

The incidence of EA in Group P was significantly reduced compared to Group C (P = .023). The number of patients who needed rescue measures was higher in Group C than in Group P (P = .041). The PACU discharge time in Group P was significantly shorter than in Group C (P < .001). The heart rate of the pediatric patients in Group P was significantly lower than in Group C at the point of discharge from PACU to the ward (P = .003), while the oxygen saturation (SpO₂) and the mean arterial blood pressure were comparable between the two groups (P > .05).

Conclusions

Pediatric patients discharged to their parents under sedated status could reduce the incidence of EA undergoing strabismus surgery.