Emergence Agitation after Sedation or Anesthesia

Important information:

“Emergence” is the process of waking up after medicines used for sedation or anesthesia wear off.  Emergence agitation is a short period of confusion, restlessness, or unusual behavior that can happen when someone wakes up too early after sedation or anesthesia. It is temporary and the length of time that it lasts can vary. 

Emergence agitation is not common. It can happen more often in children under 2 years of age, and who were given certain medicines to help them sleep during surgery, which they breathed in through a mask. This reaction can be upsetting to watch, but your child won’t remember it and it won’t cause any lasting effects.

Symptoms:

• Screaming, crying, yelling

• Restlessness, thrashing

• Larger than normal pupils, called dilated pupils

• Easily upset, cranky, irritable

• Not recognizing family or caregivers

• Seeming scared or confused

• Unable to be comforted even by parents

Treatment:

Your child might have woken up too quickly after sedation or anesthesia. To help them relax and feel calmer, we may give a small amount of medicine to make them sleepy again. This allows them to rest, and when they wake up, the reaction should be over. 

Here are some other ways to help:

• Holding or hugging works well for smaller children.

• Wrapping children in a warm blanket can help keep them safe and calm. This works well for children of all sizes, including bigger children.

• Turning off lights and lowering sounds can make the recover space more peaceful.

• Returning to a familiar place often helps children feel less confused and agitated.

Reviewed 2/11/2025 by Allyson Marks, RN, BSN, CPN, Sandra Nichols, RN, BSN, and Laura Schera, RN, BSN