“Why do kids wake up crying after anesthesia?”

Emergence Delirium.. It's quite normal. Does not signify that your loved one was in pain.

There is a phenomenon called emergence delirium where kids are delirious when waking up from anesthesia. Many times, they don’t recognize their parents and they are not consolable. There are medications that can help with emergence delirium. The important thing to keep in mind is that they won’t remember that and there are no long term effects.

Even some adults wake up crying. Obviously more common in children because they don’t always c on prehensile what is happening to them. Anesthesia disinhibits your usual coping mechanisms and the stress and fear that were covered up preop come out as the brain is emerging. It also depends on the length of surgery and meds given. Very quick cases make it difficult to get a calm wake-up. The best approach is to prepare your child and if he wakes up crying that it’s ok and common.

The anesthetic gas most commonly used in children is sevoflurane. It’s best for kids because their airways are super sensitive and they are prone to bronchospasm and laryngospasm. Sevoflurane is the gas least likely to cause these adverse events and is, therefore, the safest for kids during a general anesthetic. Unfortunately, sevoflurane causes postop fear and agitation in most children, despite them NOT being in pain. We are unsure of the exact mechanism for this and there is no proven way to prevent it. These are some medications that can be given in the Pacu to help treat it and a Preop dose of the drug midazolam can help the patient not remember the agitation, but it still happens most of the time once the child awakens from anesthesia.