Objective: To evaluate the incidence and risk factors of emergence delirium (ED) after general and regional anesthesia in elective non-cardiac surgery.

Materials and Methods: A prospective observational study was conducted among 454 patients aged over 18 years. The incidence of ED was assessed. Perioperative and intraoperative factors were also assessed using the Richmond Agitation-Sedation Scale (RASS) and the Confusion Assessment Method (CAM) Thai version. Univariable analysis was performed followed by multivariable logistic regression.

Results: Sixty-five (14.32%) patients developed ED, of whom 9.25% presented hypoactive delirium and 5.07% presented hyperactive delirium. In multivariable analysis, patients older than 60 years [p=0.003; adjusted odds ratio (adjusted OR) 2.50], having underlying chronic kidney disease (p=0.016; adjusted OR 2.56), and anesthetic induction with etomidate (p=0.017; adjusted OR 9.60), cisatracurium (p=0.006; adjusted OR 0.35), sevoflurane (p=0.003; adjusted OR 2.52), and postoperative pain score ≤3 (p=0.010; adjusted OR 3.63) were significantly more likely to experience ED.

Conclusion: Patients aged more than 60 years, with underlying chronic kidney disease, mild pain score, and anesthetized with etomidate, cisatracurium, and sevoflurane had increased risk factors for ED. Therefore, to treat underlying disease and anesthetic medication, health providers should have essential knowledge to minimize the incidence of ED.

Keywords: Complication, Delirium, General anesthesia, Regional anesthesia, Recovery, Postoperative surgery