From the Guidelines
The term for when a patient wakes up after anesthesia is emergence. Emergence is the transition period from an anesthetized state back to consciousness and normal physiological function. During emergence, the anesthetic agents are discontinued, allowing their concentrations in the brain to decrease until the patient regains consciousness. This process can vary in duration depending on the specific anesthetic medications used, the length of the procedure, and individual patient factors such as age, weight, and overall health status. Some key points to consider during emergence include:
- Increased heart rate and blood pressure changes
- Coughing and movement as the body's systems reactivate
- Potential complications such as respiratory depression, nausea, vomiting, pain, agitation, or delirium Healthcare providers closely monitor patients during this critical phase to manage these potential complications, as stated in the guidelines for immediate post-anaesthesia recovery 1. The emergence phase is followed by the recovery period, during which patients continue to be monitored in a post-anesthesia care unit (PACU) until they are stable enough to be transferred to another unit or discharged. According to the guidelines, all patients undergoing general anaesthesia or central neuraxial blockade for surgery should be recovered in a designated area, such as a PACU 1. Additionally, the use of certain pharmacological agents, such as opioids and lidocaine, may be used to attenuate the cardiovascular and respiratory changes associated with extubation, as discussed in the difficult airway society guidelines for the management of tracheal extubation 1.
From the Research
Definition of the Term
- The term when a patient wakes up after anesthesia is referred to as "emergence from anesthesia" 2, 3.
- This stage of general anesthesia features the patient's progression from unconsciousness to wakefulness and restoration of consciousness 3.
Delayed Emergence
- Delayed emergence from anesthesia, also known as delayed awakening, may occur when a patient takes longer than expected to wake up from anesthesia 4, 3.
- This phenomenon is associated with delays in the operating room and an overall increase in costs 3.
Emergence Agitation
- Emergence agitation (EA) is a self-limited state of psychomotor excitement during awakening from general anesthesia 5.
- EA is confined to the emergence period as consciousness is restored, which sharply distinguishes it from other postoperative delirium states 5.
Postanesthesia Care
- General anesthesia and mechanical ventilation impair pulmonary function, even in normal individuals, and result in decreased oxygenation in the postanesthesia period 6.
- The appropriate use of anesthetic and analgesic techniques, when combined with meticulous postoperative care, clearly influences pulmonary outcomes in the postanesthesia care unit (PACU) 6.