ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Anesthesiology and Animal Pain Management
Volume 12 - 2025 | doi: 10.3389/fvets.2025.1623761
Emergence delirium in small animals: a first step towards an objective assessment
Provisionally accepted
- 1Vetsuisse Faculty, Department of Clinical Veterinary Medicine, Section of Anaesthesiology and Pain Therapy, University of Bern, Bern, Switzerland, Bern, Switzerland
- 2Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA, Gainesville, United States
- 3Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada, Saint-Hyacinthe, Canada
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1.1. IntroductionEmergence Delirium (ED) is a condition characterized by agitation, confusion and disorientation that can occur in human patients during recovery from anesthesia. In veterinary medicine, a similar phenomenon is observed, but the frequency of occurrence and the characteristics of symptoms are not yet well defined. This study aimed to identify ED symptoms in dogs and cats, explore their occurrence, and recognize related factors.1.2. Materials and MethodsIn this prospective observational study anesthesia providers systematically, recorded symptoms observed in patients during the recovery phase following anesthesia. The study was divided into three phases.Phase 1: a group of six veterinary anesthesiologists created a list of symptoms possibly related to ED in small animals. Phase 2: demographic and anesthesia-related data were collected for dogs and cats undergoing general anesthesia at the veterinary teaching hospital of the University of Bern between May 2022 and January 2023. The occurrence of ED symptoms was analyzed and based on the occurrence of the listed ED symptoms, animals were assigned to 2 groups: NED group (No-ED group; less than four symptoms observed); ED group (four or more symptoms observed). Phase 3: a logistic regression analysis was performed to explore potential associations between ED occurrence and subject or anesthesia related factors.1.3. ResultsPhase 1: based on expert agreement, six symptoms were selected: nystagmus, paddling, opisthotonos, uncoordinated/violent movement, vocalization, and biting.Phase 2: data were recorded from 184 animals (139 dogs, 45 cats). The most common ED symptoms occurring were uncoordinated movement (41%), vocalization (36%) and paddling (30%). More than half of the study population (104/184, 57%) showed at least one symptom of ED; 14% (26/184) of the animals were included in the ED group.Phase 3: no association between subject or anesthesia related factors and the occurrence of ED was found in the univariable analysis. 1.4. ConclusionBased on the proposed list of symptoms, post anesthetic ED seems to occur frequently in small animals. The observations conducted in the present study can help further evaluation of this phenomenon in dogs and cats.
Keywords: emergence, Delirium, Recovery, score, Dogs, Cats, Dysphoria, Anesthesia
Received: 06 May 2025; Accepted: 04 Jun 2025.
Copyright: © 2025 Mattei, Chiavaccini, Spadavecchia and Mirra. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Larissa Irina Mattei, Vetsuisse Faculty, Department of Clinical Veterinary Medicine, Section of Anaesthesiology and Pain Therapy, University of Bern, Bern, Switzerland, Bern, Switzerland
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