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Hypnotic depth and the incidence of emergence agitation and negative postoperative behavioral changes

Debra J Faulk1, Mark D Twite, Jeannie Zuk

  • 1Department of Anesthesiology, The Children's Hospital, Denver, CO 80045, USA. Debra.Faulk@ucdenver.edu

Paediatric Anaesthesia
|December 9, 2009
PubMed

Insights

Deep hypnosis duration during anesthesia did not correlate with emergence agitation or postoperative behavioral changes in children. This study found no link between Bispectral Index (BIS) values and these common pediatric behavioral issues.

Area of Science:

  • Pediatric Anesthesiology
  • Neuroscience
  • Behavioral Science

Background:

  • Emergence agitation (EA) and negative postoperative behavioral changes (NPOBC) are frequent in children undergoing anesthesia.
  • The underlying causes of EA and NPOBC remain incompletely understood.

Purpose of the Study:

  • To investigate the correlation between prolonged deep hypnotic states, measured by Bispectral Index (BIS), and the incidence of EA and NPOBC in pediatric patients.
  • To determine if deeper or longer hypnotic states increase the risk of emergence agitation or negative behavioral changes post-discharge.

Main Methods:

  • 400 children (1-12 years) undergoing dental procedures under general anesthesia were monitored using BIS.
  • Deep hypnosis was defined as a BIS reading <45.
  • EA was assessed using the Pediatric Anesthesia Emergence Delirium scale; NPOBC were evaluated via parental questionnaire post-discharge.

Main Results:

  • The incidence of EA was 27%, and NPOBC was 8.8%.
  • No statistically significant differences in the occurrence of EA or NPOBC were observed based on the duration of deep hypnosis (BIS < 45).

Conclusions:

  • The study found no significant correlation between the duration of deep hypnosis (BIS < 45) and the incidence of emergence agitation or negative postoperative behavioral changes in children.
  • These behavioral disturbances in the pediatric population do not appear to be linked to the length of time spent in a deep hypnotic state during anesthesia, as indicated by BIS monitoring.
Abstract

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