PURPOSE: Emergence agitation (EA) is a postoperative behavioral disorder characterized by a lack of connection between consciousness and behavior. Despite its clinical importance and prevalence in the postoperative setting, the research focus and knowledge structure remain to be systematically mapped. Therefore, we conducted a bibliometric analysis from 1978 to 2023 to address this gap. This study aims to excavate research hotspots, map knowledge structure, uncover emerging trends, and provide invaluable insights for guiding future research endeavors.
DESIGN: A bibliometric analysis of emergency agitation.
METHODS: We conducted a literature search in the Web of Science Core Collection for articles on EA published between 1978 and 2023. We collected data on countries, institutions, journals, authors, citations, and keywords. Subsequently, we comprehensively analyzed the gathered knowledge units using three tools, including VOSviewer, HistCite Pro, and ArcGIS Pro.
FINDINGS: From 1978 to 2023, we retrieved 948 pieces of literature on EA, with the number of publications increasing yearly. China ranked first in the number of publications (n = 253, 26.69%). The United States was the most cited and influential country, closely collaborating with other countries (5,661 citations, H-index 57, citations per publication 37.99, total link strength [TLS] 24). Yonsei University was the most productive and influential institution (n = 18, 1.9%, 427 citations, H-index 12, citations per publication 23.72). Shanghai Jiao Tong University had close collaborative relationships with other universities (TLS 7). The journal with the most publications and influence was Pediatric Anaesthesia (n = 46, 4.92%, H-index 32). Anaesthesia and Analgesia was the most cited journal (2,849 citations). M.T. Aouad was the most influential and productive author devoted to studying EA (n = 6, 0.63%, 173 citations, TLS 3,002). The most influential reference was "Greater incidence of delirium during recovery from sevoflurane anaesthesia in preschool boys" (author J. Aono, No. 19, IF = 8.8, Q1, local citation score 147). Hot research directions in EA include EA and emergence delirium, propofol and EA, risk factors of EA, EA in pediatric anaesthesia, dexmedetomidine, and EA induced by sevoflurane. Esketamine, nalbuphine, sugammadex, and dezocine are drugs that have received increased attention in recent years.
CONCLUSIONS: The study mapped the knowledge structure of EA and identified six prominent research directions, four drugs of significant research interest, and emerging thematic trends. These findings offer insights into the current state of research on EA, providing a comprehensive view of the field's landscape.
