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Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery: a randomised controlled

Y Lin1, W Shen1, Y Liu2

  • 1Department of Anaesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.

British Journal of Anaesthesia
|July 24, 2018
PubMed

Insights

Visual preconditioning with an eyepatch significantly reduces emergence delirium in children undergoing eye surgery. This simple intervention lowers the incidence and severity of delirium, though it may slightly increase recovery time.

Area of Science:

  • Pediatric Anesthesiology
  • Ophthalmology
  • Child Psychology

Background:

  • Emergence delirium is a frequent complication in pediatric ophthalmic surgery.
  • Preschool-aged children are particularly susceptible to this post-anesthetic complication.
  • Visual disturbance is a suspected contributing factor.

Purpose of the Study:

  • To evaluate the efficacy of visual preconditioning in preventing emergence delirium.
  • To assess the impact of prophylactic eyepatch use on post-operative delirium.
  • To investigate the effect on emergence and recovery times.

Main Methods:

  • A prospective, blinded, randomized study involving 179 children (3-7 years) undergoing unilateral cataract surgery.
  • Participants were randomized into two groups: visual preconditioning (eyepatch) or programmed explanation.
  • Emergence delirium was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.

Main Results:

  • The visual preconditioning group showed a significantly lower incidence of emergence delirium (16.9% vs. 44.4%).
  • Maximal PAED scores were significantly lower in the preconditioning group.
  • Visual preconditioning was associated with prolonged emergence time and post-anesthesia care unit (PACU) stay.

Conclusions:

  • Visual disturbance plays a role in emergence delirium for children undergoing ophthalmic surgery.
  • Prophylactic eyepatch treatment is an effective strategy to reduce emergence delirium in this population.
  • While effective, the intervention requires consideration of potential impacts on recovery duration.
Abstract

Keywords:
anaesthesia recovery periodanaesthetics inhalationchildemergence deliriumlens diseases

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