Pediatric Emergence Delirium in the Post-Anesthesia Care Unit (PACU): Assessment, Prevention, and Family-Centered Management

Emergence delirium (ED) is a well-recognized neurobehavioral disturbance occurring in pediatric patients during recovery from general anesthesia. Characterized by agitation, confusion, inconsolability, and lack of awareness of surroundings, ED presents significant challenges for post-anesthesia care unit (PACU) nurses, anesthesiologists, and families. The condition may lead to patient harm, increased parental anxiety, prolonged PACU stays, and dissatisfaction with perioperative care. This narrative review synthesizes current evidence on pediatric emergence delirium, including its historical background, pathophysiology, risk factors, assessment tools, and multidisciplinary management strategies across the perioperative continuum. Special emphasis is placed on non-pharmacological preparation, intraoperative anesthetic choices, post-anesthesia nursing interventions, and structured parental involvement within a family-centered care framework. By integrating validated delirium scoring systems with practical PACU workflows, this work provides a comprehensive and clinically relevant resource for pediatric perioperative teams and supports quality improvement and patient safety initiatives.