Emergence delirium subsequent to general anesthesia in service members who served during the global war on terrorism.

Abstract

The primary aims of this study were to investigate, through active duty Army anesthesia provider's perceptions, the following: 1) the extent and seriousness of emergence delirium (ED) in service members; 2) effects of ED on the safety of service members and OR/PACU personnel and 3) behaviors relevant to ED in service members. In addition to these primary aims, the study also focused on identifying through provider's perceptions, the following potential factors which may lead to the development of ED or to the alleviation of ED: 1) type of anesthetic agents; 2) physiological factors; 3) psychological factors; and 4) interventions used for alleviating the symptoms of ED. A final aim was to investigate from provider's perceptions, the relationship between perceived seriousness of ED and reported case experience, behaviors and consequences relevant to ED, and physiological and psychological factors related to the development or alleviation of ED symptoms. This research utilized a descriptive correlational study design with a questionnaire survey and a convenience sampling technique totaling 89 active duty Army anesthesia providers. This study found that over 78% of active duty Army anesthesia providers have witnessed ED in their particular practice. Approximately 38% of the respondents felt that ED was a moderate problem. There was a statistically significant association between perceived severity of ED and ED case experience. The behaviors which were often seen or always seen included hyperactive motor behavior, pulling at the monitoring equipment, and making disruptive movements. The current study found that the majority of anesthesia providers with ED case experience believed ED could be related to the anesthetic used. The anesthetic identified most strongly as potentially related to ED were potent inhalation agents (PIA's). Most of the providers with ED case experience believed physiological factors and psychological factors were related to ED. Over ninety percent of the providers with ED case experience reported that they intervened when their patients showed behaviors related to ED with the majority of the providers stating they talked to the patient during the ED episode.