{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:54:05Z","timestamp":1789430045831,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Specific University Research provided by M\u0160MT","award":["MUNI\/A\/1166\/2021"],"award-info":[{"award-number":["MUNI\/A\/1166\/2021"]}]},{"name":"Specific University Research provided by M\u0160MT","award":["MUNI\/A\/1178\/2021"],"award-info":[{"award-number":["MUNI\/A\/1178\/2021"]}]},{"name":"Specific University Research provided by M\u0160MT","award":["FNBr, 65269705"],"award-info":[{"award-number":["FNBr, 65269705"]}]},{"name":"MH CZ\u2014DRO","award":["MUNI\/A\/1166\/2021"],"award-info":[{"award-number":["MUNI\/A\/1166\/2021"]}]},{"name":"MH CZ\u2014DRO","award":["MUNI\/A\/1178\/2021"],"award-info":[{"award-number":["MUNI\/A\/1178\/2021"]}]},{"name":"MH CZ\u2014DRO","award":["FNBr, 65269705"],"award-info":[{"award-number":["FNBr, 65269705"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, agitation, and are at higher risk of unintentional extraction of an intravenous cannula, self-harm and nausea and vomiting. The described incidence of ED varies between 25\u201380%, with a higher prevalence among children younger than 6 years of age. We aimed to determine the incidence of ED in pediatric patients (&gt;1 month) after general anesthesia in the post-anesthesia care unit (PACU), using Paediatric Anaesthesia Emergence Delirium (PAED) score, Watcha score and Richmond agitation and sedation scale (RASS). The incidence of ED was the highest in the PAED score with cutoff \u226510 points (89.0%, n = 1088). When using PAED score &gt;12 points, ED incidence was 19.3% (n = 236). The lowest incidence was described by Watcha and RASS scores, 18.8% (n = 230) vs. 18.1% (n = 221), respectively. The threshold for PAED \u226510 points seems to give false-positive results, whereas the threshold &gt;12 points is more accurate. RASS scale, although intended primarily for estimation of the depth of sedation, seems to have a good predictive value for ED.<\/jats:p>","DOI":"10.3390\/children9101591","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:34:30Z","timestamp":1666312470000},"page":"1591","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Incidence of Emergence Delirium in the Pediatric PACU: Prospective Observational Trial"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5073-9415","authenticated-orcid":false,"given":"Eva","family":"Klabusayov\u00e1","sequence":"first","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Musilov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Fabi\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Sk\u0159\u00ed\u0161ovsk\u00e1","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1370-7086","authenticated-orcid":false,"given":"V\u00e1clav","family":"Vafek","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Kosinov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"\u0164ouk\u00e1lkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e9la","family":"Vrtkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, VSB\u2014Technical University of Ostrava, 70800 Ostrava, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozef","family":"Klu\u010dka","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"\u0160toura\u010d","sequence":"additional","affiliation":[{"name":"Department of Paediatric Anaesthesia and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"},{"name":"Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/bjaceaccp\/mks051","article-title":"Paediatric Emergence Delirium","volume":"13","author":"Reduque","year":"2013","journal-title":"Contin. Educ. Anaesth. Crit. Care Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1097\/00000542-200405000-00015","article-title":"Development and Psychometric Evaluation of the Pediatric Anesthesia Emergence Delirium Scale","volume":"100","author":"Sikich","year":"2004","journal-title":"Anesthesiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e043968","DOI":"10.1136\/bmjopen-2020-043968","article-title":"Risk Prediction Models for Emergence Delirium in Paediatric General Anaesthesia: A Systematic Review","volume":"11","author":"Petre","year":"2021","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/pan.12038","article-title":"Emergence Delirium in Children: A Comparison of Sevoflurane and Desflurane Anesthesia Using the Paediatric Anesthesia Emergence Delirium Scale","volume":"23","author":"Locatelli","year":"2013","journal-title":"Pediatr. Anesth."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1093\/bja\/aew477","article-title":"Paediatric Emergence Delirium: A Comprehensive Review and Interpretation of the Literature","volume":"118","author":"Mason","year":"2017","journal-title":"Br. J. Anaesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e037346","DOI":"10.1136\/bmjopen-2020-037346","article-title":"Publication Bias in Pediatric Emergence Delirium: A Cross-Sectional Analysis of ClinicalTrials.Gov and ClinicalTrialsRegister.Eu","volume":"10","author":"Meyburg","year":"2020","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/bja\/aev552","article-title":"Emergence Delirium or Pain after Anaesthesia\u2014How to Distinguish between the Two in Young Children: A Retrospective Analysis of Observational Studies","volume":"116","author":"Somaini","year":"2016","journal-title":"Br. J. Anaesth."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1046\/j.1460-9592.2003.00948.x","article-title":"Rapid Emergence Does not Explain Agitation following Sevoflurane Anaesthesia in Infants and Children: A Comparison with Propofol","volume":"13","author":"Cohen","year":"2003","journal-title":"Pediatr. Anesth."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11920-017-0817-3","article-title":"Pediatric Delirium: Evaluation, Management, and Special Considerations","volume":"19","author":"Malas","year":"2017","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_10","first-page":"2","article-title":"Delirium in the PICU","volume":"28","author":"Mehta","year":"2019","journal-title":"Qatar Med. J."},{"key":"ref_11","first-page":"55","article-title":"Effect of Propofol on Emergence Behavior in Children after Sevoflurane General Anesthesia","volume":"18","year":"2007","journal-title":"Pediatr. Anesth."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"471","DOI":"10.4097\/kja.20097","article-title":"Emergence Agitation: Current Knowledge and Unresolved Questions","volume":"73","author":"Lee","year":"2020","journal-title":"Korean J. Anesthesiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"110488","DOI":"10.1016\/j.jclinane.2021.110488","article-title":"Association of pharmacological prophylaxis with the risk of pediatric emergence delirium after sevoflurane anesthesia: An updated network meta-analysis","volume":"75","author":"Wang","year":"2021","journal-title":"J. Clin. Anesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/j.1460-9592.2010.03328.x","article-title":"A Comparison of Emergence Delirium Scales following General Anesthesia in Children","volume":"20","author":"Bajwa","year":"2010","journal-title":"Pediatr. Anesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s40560-016-0189-5","article-title":"Validity of the Richmond Agitation-Sedation Scale (RASS) in Critically Ill Children","volume":"4","author":"Kerson","year":"2016","journal-title":"J. Intensive Care"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"795487","DOI":"10.3389\/fped.2021.795487","article-title":"Validity and Reliability of the Richmond Agitation-Sedation Scale in Pediatric Intensive Care Patients: A Multicenter Study","volume":"9","author":"Tapia","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/pan.13348","article-title":"A Psychometric Evaluation of the Pediatric Anesthesia Emergence Delirium Scale","volume":"28","author":"Ringblom","year":"2018","journal-title":"Pediatr. Anesth."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e4927","DOI":"10.1097\/MD.0000000000004927","article-title":"Comparison of the Incidence of Emergence Agitation and Emergence Times between Desflurane and Sevoflurane Anesthesia in Children: A Systematic Review and Meta-Analysis","volume":"95","author":"Lim","year":"2016","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1097\/EJA.0000000000001490","article-title":"Dexmedetomidine vs. Total Intravenous Anaesthesia in Paediatric Emergence Delirium: A Network Meta-Analysis","volume":"38","author":"Petre","year":"2021","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1213\/00000539-200009000-00012","article-title":"Emergence Agitation after Sevoflurane Versus Propofol in Pediatric Patients","volume":"91","author":"Uezono","year":"2000","journal-title":"Anesth. Analg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1007\/s12325-020-01317-x","article-title":"Emergence Delirium in Perioperative Pediatric Care: A Review of Current Evidence and New Directions","volume":"37","author":"Urits","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"403","DOI":"10.4103\/1658-354X.105887","article-title":"Caudal Block and Emergence Delirium in Pediatric Patients: Is It Analgesia or Sedation?","volume":"6","author":"Sinha","year":"2012","journal-title":"Saudi J. Anaesth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1097\/00000539-200205000-00023","article-title":"The Effect of Fentanyl on the Emergence Characteristics after Desflurane or Sevoflurane Anesthesia in Children","volume":"94","author":"Cohen","year":"2002","journal-title":"Anesth. Analg."},{"key":"ref_24","first-page":"500","article-title":"Combination Effect of Low Dose Fentanyl and Propofol on Emergence Agitation in Children Following Sevoflurane Anesthesia","volume":"30","author":"Bakhamees","year":"2009","journal-title":"Saudi Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1046\/j.1460-9592.2000.00560.x","article-title":"Emergence Agitation in Paediatric Patients after Sevoflurane Anaesthesia and No Surgery: A Comparison with Halothane","volume":"10","author":"Cravero","year":"2000","journal-title":"Pediatr. Anesth."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4097\/kjae.2010.59.2.75","article-title":"The Effect of Propofol on Emergence Agitation in Children Receiving Sevoflurane for Adenotonsillectomy","volume":"59","author":"Lee","year":"2010","journal-title":"Korean J. Anesthesiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3389\/fped.2020.00329","article-title":"The Effect of Dexmedetomidine on Emergence Agitation or Delirium in Children after Anesthesia\u2014A Systematic Review and Meta-Analysis of Clinical Studies","volume":"8","author":"Rao","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"897","DOI":"10.2147\/DDDT.S196075","article-title":"Dexmedetomidine for the Prevention of Emergence Delirium and Postoperative Behavioral Changes in Pediatric Patients with Sevoflurane Anesthesia: A Double-Blind, Randomized Trial","volume":"13","author":"Shi","year":"2019","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.bja.2018.01.042","article-title":"Mother\u2019s recorded voice on emergence can decrease postoperative emergence delirium from general anaesthesia in paediatric patients: A prospective randomised controlled trial","volume":"121","author":"Byun","year":"2018","journal-title":"Br. J. Anaesth."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/10\/1591\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:58:36Z","timestamp":1760144316000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/10\/1591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":29,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["children9101591"],"URL":"https:\/\/doi.org\/10.3390\/children9101591","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]}}}