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Reduced regional cerebral oxygen saturation increases risk for emergence delirium in pediatric patients
Lijing Li1, Zhengzheng Gao1, Jianmin Zhang1
1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Decreased regional cerebral oxygen saturation (rScO2) during anesthesia significantly increases the risk of emergence delirium (ED) in pediatric patients. Monitoring oxygen levels is crucial for anesthesia safety.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Neuroscience
Background:
- Emergence delirium (ED) is a common complication following general anesthesia in children.
- Regional cerebral oxygen saturation (rScO2) monitoring may offer insights into cerebral oxygenation during anesthesia.
Purpose of the Study:
- To investigate the association between intraoperative rScO2 desaturation and the incidence of ED in pediatric surgical patients.
- To identify risk factors for ED in children undergoing general anesthesia.
Main Methods:
- A retrospective observational cohort study of 113 children (aged 2-14 years) undergoing selective surgery.
- Intraoperative rScO2 was monitored using cerebral oximetry.
- The Pediatric Anesthesia Emergence Delirium (PAED) score assessed ED incidence.
Main Results:
- The incidence of ED was 31%.
- Patients with low rScO2 had a significantly higher incidence of ED (P < 0.001).
- Decreased rScO2 was strongly associated with ED (OR, 10.77), particularly in children under 3 years.
Conclusions:
- Intraoperative rScO2 desaturation is a significant predictor of ED in pediatric anesthesia.
- Enhanced monitoring of cerebral oxygenation is recommended to improve anesthesia quality and safety.
- Optimizing oxygen balance in vital organs may reduce ED incidence.
Objectives:
To assess whether decreased regional cerebral oxygen saturation (rScO2) is associated with the emergence delirium (ED) following general anesthesia in the pediatric population.
Methods:
A retrospective observational cohort study was conducted on 113 children (ASA I-III) aged 2-14 years who underwent selective surgery under general anesthesia between 2022-01 and 2022-04. Intraoperatively, the rScO2 was monitored using a cerebral oximeter. The Pediatric Anesthesia Emergence Delirium (PAED) score was used to evaluate the patients for ED.
Results:
The incidence of ED was 31%. Low rScO2 was reported in 41.6% of patients, who had a higher incidence of ED (P < 0.001) than those who did not experience desaturation. Logistic regression analysis revealed that decreased rScO2 was significantly associated with incident ED events [odds ratio (OR), 10.77; 95% confidence interval, 3.31-35.05]. Children under 3 years of age had a higher incidence of ED after rScO2 desaturation during anesthesia compared to older children (OR, 14.17 vs. 4.64).
Conclusion:
Intraoperative rScO2 desaturation significantly increased the incidence of ED following general anesthesia. Monitoring should be enhanced to improve the oxygen balance in vital organs to improve the quality and safety of anesthesia.
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