Delayed awakening and its associated factor following general anesthesia service, 2022: a cross-sectional study

Abstract

Background: The time to emerge from anesthesia is affected by patient factors, anesthetic factors, the duration of surgery, and preoperative and intraoperative pain management. Objective: This study aimed to determine the prevalence and contributing factors of delayed awakening following general anesthesia. Method: A cross-sectional study was conducted from January to June 2022. After getting ethical approval with the permission number S/C/R 37/01/2022, willing patients participate with written informed consent. Chart reviews in the preoperative and postoperative recovery rooms were used to collect data. Frequency and percentage with cross-tabulation were used to provide the descriptive statistics. To determine the predictive variables that were associated with the outcome variable, bivariable, and multivariable logistic regression models were fitted. The statistical significance was evaluated using P-values of 0.05 for multivariable regression. Results: In the current study, a normal emergency occurred in 91.7% of surgical patients receiving general anesthesia, while delayed awakening, emergence with hypoactive, and emergence with delirium occurred in 2.6, 3.9, and 1.8% of cases, respectively. Patients older than 64 years [adjusted odds ratio (AOR): 1.33, 95% CI: 0.83–7.191], being diploma anesthesia providers (AOR: 2.38, 95% CI: 2.05–7.15), opioids (AOR: 2.3, 95% CI: 2.20–5.76), surgery lasting longer than 2 h (AOR: 1.91, 95% CI: 1.83–6.14), estimated blood loss of more than 1500 ml (AOR: 1.20, 95% CI: 0.62–11.30), crystalloid administration of more than 3000 ml (AOR: 3.12, 95% CI: 2.19–7.32), intraoperative hypotension (AOR: 3.37, 95% CI: 2.93–9.41) and extreme body weight, were significantly linked to delayed awakening after general anesthesia. Conclusion: Although delayed emergence is an uncommon condition with a number of contributing causes, it is preventable, and once it has occurred, it presents a challenge for anesthetists.