Anaesthetic emergence agitation in adults following general surgery: A scoping review

Background: Anaesthetic emergence is the patient's transition from general anaesthetic until they are alert and in full control of vital reflexes. It is during this transition that significant complications, including anaesthetic emergence agitation, may occur. A preliminary search did not iden...

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Main Authors: Meredith Heily, Marie Gerdtz, Rebecca Jarden, Yen Yap, Rinaldo Bellomo
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Nursing Studies Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666142X2500030X
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author Meredith Heily
Marie Gerdtz
Rebecca Jarden
Yen Yap
Rinaldo Bellomo
author_facet Meredith Heily
Marie Gerdtz
Rebecca Jarden
Yen Yap
Rinaldo Bellomo
author_sort Meredith Heily
collection DOAJ
description Background: Anaesthetic emergence is the patient's transition from general anaesthetic until they are alert and in full control of vital reflexes. It is during this transition that significant complications, including anaesthetic emergence agitation, may occur. A preliminary search did not identify any research investigating adults who undergo anaesthetic emergence in critical care settings. Objectives: To map the post-anaesthetic literature reporting outcomes, risk factors, and management of adult patients admitted directly to a critical care unit, who develop emergence agitation, and to describe the implications for clinical practice. Methods: The scoping review was registered at https://osf.io/spwx5/ and conducted using the Joanna Briggs Institute methodology, with the framework of Population, Concept and Context. Search terms including agitation, anaesthetic, emergence, postoperative and surgery. Results: Twenty-five articles were identified and were eligible for data extraction. Risk factors included co-morbid conditions, anaesthetic agents and the presence of in-situ invasive devices. Studies varied regarding design and patient assessment tools. Data were reported from one or more of eight observation timepoints along the emergence continuum, from end-anaesthetic until post anaesthetic care unit discharge. No studies investigated patients with direct postoperative admission to critical care settings. Conclusions: This review has characterised the emergence continuum. The variations between studies has highlighted the necessity to reach future consensus regarding emergence definition and measurement. A critical gap was identified regarding recommendations for prevention and management of emergence agitation for patients admitted directly to a critical care unit.
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spelling doaj-art-9188eacecbb34599b481b1fee2b16fb22025-08-20T02:31:12ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810032010.1016/j.ijnsa.2025.100320Anaesthetic emergence agitation in adults following general surgery: A scoping reviewMeredith Heily0Marie Gerdtz1Rebecca Jarden2Yen Yap3Rinaldo Bellomo4Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia; The Royal Melbourne Hospital, Melbourne, Australia; Corresponding author at: Meredith Heily, University of Melbourne, Level 6, Alan Gilbert Building, 159 Barry St, Carlton, Twitter:@meredithheily. Australia.Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, AustraliaFaculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia; Austin Health, Melbourne, AustraliaFaculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, AustraliaFaculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia; The Royal Melbourne Hospital, Melbourne, Australia; Austin Health, Melbourne, AustraliaBackground: Anaesthetic emergence is the patient's transition from general anaesthetic until they are alert and in full control of vital reflexes. It is during this transition that significant complications, including anaesthetic emergence agitation, may occur. A preliminary search did not identify any research investigating adults who undergo anaesthetic emergence in critical care settings. Objectives: To map the post-anaesthetic literature reporting outcomes, risk factors, and management of adult patients admitted directly to a critical care unit, who develop emergence agitation, and to describe the implications for clinical practice. Methods: The scoping review was registered at https://osf.io/spwx5/ and conducted using the Joanna Briggs Institute methodology, with the framework of Population, Concept and Context. Search terms including agitation, anaesthetic, emergence, postoperative and surgery. Results: Twenty-five articles were identified and were eligible for data extraction. Risk factors included co-morbid conditions, anaesthetic agents and the presence of in-situ invasive devices. Studies varied regarding design and patient assessment tools. Data were reported from one or more of eight observation timepoints along the emergence continuum, from end-anaesthetic until post anaesthetic care unit discharge. No studies investigated patients with direct postoperative admission to critical care settings. Conclusions: This review has characterised the emergence continuum. The variations between studies has highlighted the necessity to reach future consensus regarding emergence definition and measurement. A critical gap was identified regarding recommendations for prevention and management of emergence agitation for patients admitted directly to a critical care unit.http://www.sciencedirect.com/science/article/pii/S2666142X2500030XAgitationAnaesthesiaCritical careEmergenceIntensive carePostoperative
spellingShingle Meredith Heily
Marie Gerdtz
Rebecca Jarden
Yen Yap
Rinaldo Bellomo
Anaesthetic emergence agitation in adults following general surgery: A scoping review
International Journal of Nursing Studies Advances
Agitation
Anaesthesia
Critical care
Emergence
Intensive care
Postoperative
title Anaesthetic emergence agitation in adults following general surgery: A scoping review
title_full Anaesthetic emergence agitation in adults following general surgery: A scoping review
title_fullStr Anaesthetic emergence agitation in adults following general surgery: A scoping review
title_full_unstemmed Anaesthetic emergence agitation in adults following general surgery: A scoping review
title_short Anaesthetic emergence agitation in adults following general surgery: A scoping review
title_sort anaesthetic emergence agitation in adults following general surgery a scoping review
topic Agitation
Anaesthesia
Critical care
Emergence
Intensive care
Postoperative
url http://www.sciencedirect.com/science/article/pii/S2666142X2500030X
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AT mariegerdtz anaestheticemergenceagitationinadultsfollowinggeneralsurgeryascopingreview
AT rebeccajarden anaestheticemergenceagitationinadultsfollowinggeneralsurgeryascopingreview
AT yenyap anaestheticemergenceagitationinadultsfollowinggeneralsurgeryascopingreview
AT rinaldobellomo anaestheticemergenceagitationinadultsfollowinggeneralsurgeryascopingreview