Assessing behaviour in children emerging from anaesthesia: can we apply psychiatric diagnostic techniques?

Area of Science:

• Pediatric Anesthesiology
• Child Psychology
• Psychiatric Assessment

Background:

• Lack of standardized tools for assessing emergence behavior in children post-anesthesia.
• Need for a systematic method using psychiatric principles to evaluate behavior changes.

Purpose of the Study:

• To develop and evaluate an assessment tool for children's behavior before and after anesthesia.
• To categorize emergence behavior using psychiatric terminology.

Main Methods:

• Prospective study of 25 children (2-9 years) undergoing strabismus repair.
• Behavior assessment pre-induction and for 30 minutes post-emergence using a DSM-IV-guided tool.
• Randomized maintenance anesthesia: intravenous remifentanil vs. inhaled isoflurane.

Main Results:

• 44% of children showed altered emergence behavior; 20% exhibited delirium symptoms.
• Higher scores in children receiving isoflurane vs. remifentanil (P=0.04).
• Younger children (<62 months) were more prone to altered behavior (P=0.02).

Conclusions:

• Post-anesthetic behavioral changes, including distress and delirium, can be classified using DSM-IV terminology.
• Emergence behavior is influenced by patient age and anesthetic technique.
• The developed tool offers a systematic approach to evaluating post-anesthetic behavior in pediatric patients.