Background and Goal of Study: 
Although pediatric emergence delirium (ED) is a frequent (10 to 80%)1 complication occurring after anesthesia in children, evidence on different pharmacological and non-pharmacological preventive and therapeutic approaches is partially vague. General anesthesia in children may be related to adverse effects on children’s brain development; ED may be involved. 
As one of the most important Tertiary Care Pediatric Center in Spain, Hospital Sant Joan de Déu Barcelona aims to reach the highest quality level of anesthesia performance. In order to explore ED characteristics in our institution we have sought to elicit the experience and opinions of our professionals about definitions and diagnostic criteria for ED, preventive strategies, treatments, and their perceived efficacy. 
Materials and Methods: A web-based survey was sent to the 40 pediatric anesthesiologists working at our academic health science center. It was based on a previous published survey on the topic2 designed to elicit the opinions and practice around pediatric ED by an experienced set of pediatric anesthesiologists.

Results and Discussion: 
The response rate was 90% (36/40). Of respondents, 56% felt that ED was a significant problem at our institutions, with 69% giving medication before or during anesthesia to prevent the development of ED. Midazolam was the most common medication given to prevent ED (86%) and propofol the most frequet chosen drug to treat ED (51%). Only 11% considered total intravenous anesthesia (TIVA) a technique used to prevent ED. Medications used for treatment included propofol (51%), midazolam (46%) and fentanyl (3%) as a first line treatment, with 80% of respondents rating effectiveness of treatment as ‘usually works quickly with one dose’. Surprisingly only 1/36 responders declare rutinary scale ED.

Conclusions: 
We have discover lack of ED scaling and inhomogeneous preventive and therapeutic approaches to ED in our institution. 
A local prospective observational research is being conducted, our goal is to define actual practice. We aim to archive a stepwise clinical intervention algorithm.

References: 
1Emergence Delirium in Pediatric Anesthesia. Moore AD, Anghelescu DL. Paediatr Drugs. 2017 Feb;19(1):11-20. doi: 10.1007/s40272-016-0201-5. 
2Rosen HD, Mervitz D, Cravero JP. Pediatric emergence delirium: Canadian pediatric anesthesiologists’ experience. Paediatr Anaesth 2016; 26(2): 207-212. doi: 10.1111/pan.12812 

06 / Pediatric emergence delirium from the anesthesiologist´s point of view: a survey at our Tertiary Care Pediatric Center Sant Joan de Déu Hospital Barcelona