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Relationship between Fasting Times and Emergence Delirium in Children Undergoing Magnetic Resonance Imaging under
Ayşe Neslihan Balkaya1, Canan Yılmaz1, Çağdaş Baytar2
1Department of Anesthesiology and Reanimation, Bursa Yuksek Ihtisas Training and Research Hospital, Health Sciences University, Bursa 16310, Turkey.
Insights
Prolonged preoperative fasting and thirst in children undergoing MRI sedation are linked to increased postoperative emergence delirium (ED). Shorter fasting times may help reduce ED incidence in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Neuroimaging
- Patient Safety
Background:
- Postoperative emergence delirium (ED) is a common concern in pediatric patients undergoing sedation for procedures like MRI.
- Understanding risk factors for ED is crucial for improving patient outcomes and recovery.
Purpose of the Study:
- To investigate the association between preoperative fasting duration (including solid food and fluid intake), fasting blood glucose (FBG), and the incidence of ED in pediatric patients undergoing MRI under sedation.
- To identify specific fasting parameters that act as risk factors for ED.
Main Methods:
- A study involving 110 pediatric patients undergoing MRI under sedation.
- Preoperative fasting times (solid, fluid, and thirst) and FBG levels were recorded.
- Emergence delirium was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale in the recovery room.
Main Results:
- No significant association was found between FBG levels and PAED scores.
- A weak positive correlation was observed between prolonged fasting time (solid food and thirst) and higher PAED scores in the initial recovery minutes.
- The incidence of ED was 34.5% in the study population.
Conclusions:
- Prolonged preoperative fasting times for solids, fluids, and thirst are identified as significant risk factors for developing postoperative emergence delirium in children undergoing MRI sedation.
- Optimizing preoperative fasting protocols may help mitigate the risk of ED in this patient population.
Abstract:
Background and Objectives: This study aimed to determine whether there is a relationship between preoperative fasting time, fasting blood glucose (FBG), and postoperative emergence delirium (ED) in pediatric patients undergoing MRI under sedation. Materials and Methods: 110 pediatric patients were included in the study. Preoperative fasting (solid-fluid) time and FBG were recorded. The development of ED in the patients who underwent MRI under sedation was evaluated with the pediatric anesthesia emergence delirium (PAED) value for 30 min every 5 min in the recovery room. PAED score of ≥10 was grouped as having ED, and a PAED score of <10 as without ED at any time. The PAED scores were compared with other variables, ASA, age, weight, MRI examination time, and FBG level and fasting times. The risk factors affecting the occurrence of ED were examined. Results: Mean age was 3.94 ± 1.53 years, mean FBG was 106.97 ± 12.53 mg/dL, fasting time was 10.75 ± 2.61 h, solid food fasting time was 11.92 ± 2.33 h, and thirst time was 10.74 ± 2.58 h. FBG was never associated with PAED measurement at any time (p > 0.05). There was a weak positive correlation between the fasting time and the 0th, 5th, and 10th minute PAED score (r = 0.225; p = 0.018, r = 0.195; p = 0.041, r = 0.195; p = 0.041). There was a weak positive correlation between the solid food fasting time and the PAED score at the 0th, 5th, 10th, 15th, and 20th minutes (r = 0.382; p < 0.001, r = 0.357; p < 0.001, r = 0.345; p < 0.001, r = 0.360; p < 0.001, r = 0.240; p < 0.001). There was a weak positive correlation between thirst time and the PAED score at the 0th, 5th, and 10th minutes (r = 0.222; p = 0.020. r = 0.192; p = 0.045, r = 0.199; p = 0.037). The incidence of ED at any time was 34.5%. Conclusions: Prolonged fasting time, solid food fasting time and thirst time are risk factors for developing postoperative ED in children undergoing MRI under sedation.
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