A Thesis Report Submitted to Department of Anesthesia and Critical Care, College of Medicine and Health Sciences, University of Gondar in the Partial Fulfillment of the Requirements for Degree of Masters of Sciences in Advanced Clinical Anesthesia.

Abstract

Abstract Background: Emergence delirium in elderly patient continues to be a significant problem in the post-anesthetic care environment interfering with patient recovery period and proving to be a challenge to attending staffs. Objective: To determine the incidence and associated factors of emergence delirium after anesthesia in elderly patients at post anesthesia care unit in University of Gondar Comprehensive Specialized Hospital, North West Ethiopia 2020. Methods: An institution based cross-sectional study was conducted from February 20, to May 20, 2020 in University of Gondar Comprehensive Specialized Hospital, after ethical approval taken from the review committee. A total of 172 elderly participants were included. Emergence delirium was assessed by Richmond agitation sedation scale. Statistical analysis was done by using statistical package for social sciences version 20. Bivariable binary logistic regression analysis was performed to determine whether each of independent variables was associated or not with the outcome variable. Only variables with pvalue less than 0.2 were entered into the multivariable binary logistic regression analysis. Both Crude and Adjusted Odds Ratios with 95% CI were calculated to show strength of association. Variables with P-value of <0.05 were considered to be statistically significant. Result: In this study the incidence of emergence delirium after anesthesia in elderly patients at post anesthesia care unit was 40.7% (95%CI: 32, 48). perioperative intravenous narcotic used, (AOR:5.1,95%CI:1.265,20.565), intraoperative excessive blood loss (AOR:6.5,95%CI: 2.47,17.02), postoperative pain (AOR:3.9,95%CI:1.134,13.596), and preoperative anxiety (AOR:7,95%CI:1.757,28.549), were significantly associated with emergence delirium after anesthesia in elderly patients at post anesthesia care unit. Conclusion and recommendation: In our study perioperative intravenous narcotic used, intraoperative excessive blood loss, postoperative pain, and preoperative anxiety were significantly associated with emergence delirium. Reassuring of patients preoperatively and gave full information about anesthesia as well as the procedure and adequate post operative pain management decreased the magnitude of emergence delirium