The effectivity of ear plug utilization on emergence delirium incidence in pediatric patient undergoing general inhalated anesthesia

Background: Emergence delirium (ED) also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors such as agitation, irritable, uncompromising, uncooperative, inconsolably crying following general anesthesia. A high noise level in the operating room can be reduced with an earplug application. This study aimed to see the effectiveness of earplug utilization in reducing the incidence of emergence delirium without extending the time of extubation compared to control patients. Methods: This is a double-blind, randomized clinical trial towards 1-5 years old patients underwent inhalational general anesthesia in Dr. Cipto Mangunkusumo hospital in 2018. They were assigned to either the Earplug (E) group with an application of an earplug at the end of the surgery or Control (C) group, without the use of an earplug. The incidence of ED was measured using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Data were analyzed using multivariate logistic regression and analysis of covariance tests. Results: Incidence of ED in earplug group was 16.7% while in control group was 32.1% (OR = 0.402, CI95%=0.152-1.062, p=0.066). The mean time-to-extubation in E vs. C groups were 5.76±3.23 vs. 6.54±3.67 minutes, respectively. Conclusion: The application of an earplug at the end of anesthesia was not statistically effective to reduce the incidence of ED in 1-5 years old patients underwent inhalational general anesthesia.