Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial

Figures & data

Table 1 Patients’ demographic data

Variables	Total patients (N=40)	Mild withdrawal (n=27)	Severe withdrawal (n=13)	P-value
Age (years)	3 (2–5)	4 (2–5)	3 (2–4)	0.317
Body weight (kg)	14.2 (12.0–17.6)	15 (15.5–21.5)	13.5 (11.0–15.3)	0.141
Height (cm)	95.4 (87.3–109.0)	99.0 (88.0–112.0)	91.0 (85.1–106.2)	0.133
Sex (M/F)	28/12	19/8	9/4	0.941
Operation time (min)	15.0 (15.0–23.8)	15.0 (10.0–20.0)	20.0 (15.0–25.0)	0.156
Anesthesia time (min)	40.0 (35.0–45.0)	40.0 (35.0–45.0)	35.0 (35.0–45.0)	0.563

Notes: Values are reported as median (interquartile range) and number of patients. P-values were calculated using the Mann–Whitney U-test and Fisher’s exact test. All tests were two-sided.

Abbreviations: M, male; F, female.

Figure 1 Correlation between the severity of withdrawal movement following rocuronium injection and severity of EA on admission to the PACU.

Notes: The Kendall’s tau was estimated as 0.29. The diameters of the plotted circles are proportional to the number of patients.
Abbreviations: EA, emergence agitation; PACU, postanesthesia care unit.

Table 2 Severity of withdrawal movement following rocuronium injection during anesthesia induction and severity of EA on admission to the PACU

Watcha scale for EA on admission to the PACU	Withdrawal movement following rocuronium injection
	0	1	2	3
1	4	3	8	3
2	0	2	4	3
3	0	1	1	1
4	1	1	2	6

Notes: Withdrawal movement: 0= no response, 1= movement at the wrist only, 2= movement/withdrawal involving the arm only (elbow/shoulder), and 3= generalized response, movement/withdrawal in more than one extremity. Watcha scale for EA: 1= calm; 2= crying, but can be consoled; 3= crying, cannot be consoled; and 4= agitated and thrashing around.

Abbreviations: EA, emergence agitation; PACU, postanesthesia care unit.

Table 3 EA according to mild and severe withdrawal reactions

Variables	Mild withdrawal (n=27)	Severe withdrawal (n=13)	P-value
EA severity ≥3	6 (22.2%)	7 (53.8%)*	0.048
Interval from the end of surgery to initial fentanyl administration (min)	19 (16.25–27.75)	9.5 (4.25–18.5)*	0.045
Cases of fentanyl use	15 (55.6%)	10 (76.9%)
Fentanyl consumption (µg/kg)	0.5 (0–0.5)	0.5 (0.5–0.5)	0.383
Duration of stay in PACU (min)	40 (40–44)	40 (40–40)	0.562

Notes: Values are reported as median (interquartile range) and number (proportion) of patients. P-values were calculated using the Mann–Whitney U-test, and all tests were two-sided.

* P<0.05 compared to the mild withdrawal group.

Abbreviations: EA, emergence agitation; PACU, postanesthesia care unit.