Acupuncture Therapy for Prevention of Emergence Delirium in Children Undergoing General Anesthesia

Background: Emergence delirium may be experienced by 12%-50% of children undergoing general anesthesia. Pharmacological interventions used for management of emergence delirium may result in sedation and longer recovery time from anesthesia. Objective: To evaluate the effectiveness of acupuncture therapy for prevention of emergence delirium. Design, Setting, and Patients: A retrospective review of the Seattle Children's Hospital anesthesiology department acupuncture database of children diagnosed with emergence delirium after general anesthesia who had acupuncture therapy with needle stimulation at SP 6, HT 7, LR 3, and magnets at ear Shenmen area in a subsequent anesthetic for the same procedure. Patients undergoing different anesthetic techniques or different procedures were excluded. The database included cases from July 2004 to January 2006. Main Outcome Measures: Symptoms of emergence delirium Results: Twelve patients, aged 2 to 17 years (median, 4 years), 58% males, were included. The most common procedure (n = 10) was lumbar puncture with administration of intrathecal chemotherapy and/or bone marrow aspirate done under total intravenous anesthesia with alfentanil and propofol. After the acupuncture intervention, 10 patients (83%) did not exhibit symptoms of emergence delirium, and 2 patients (17%) exhibited milder symptoms with crying and irritability but were able to communicate the source of distress. Additionally, in the total intravenous anesthesia group, patients received less propofol when comparing anesthetic requirements before and after the intervention. No complications were reported in any of the patients. Conclusion: Our experience suggests that acupuncture therapy is a safe, non-pharmacological option for prevention of emergence delirium in children undergoing general anesthesia.