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Published on: September 6, 2017
Analysis of the relationship between EEG burst suppression and poor prognosis in children under general anaesthesia:
Qian Xu1, Jianmin Zhang2, Zhengzheng Gao1
1Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No.56, South Lishi Road, Beijing, 100045, China.
Insights
This study found that burst suppression (BS) on electroencephalogram (EEG) during general anesthesia in children is linked to postoperative delirium. This discovery may help prevent emergence delirium and other adverse outcomes in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Neurophysiology
- Critical Care Medicine
Background:
- Emergence delirium (ED) is a common postoperative behavioral change in children.
- Burst suppression (BS) on EEG signifies profound brain inactivation.
- The association between intraoperative BS and ED remains unclear.
Purpose of the Study:
- To investigate the relationship between intraoperative burst suppression (BS) on electroencephalogram (EEG) and the incidence of postoperative emergence delirium (ED) in children.
- To explore the association between BS and other adverse outcomes like prolonged awakening and extubation difficulties.
Main Methods:
- Prospective, observational cohort study conducted at Beijing Children's Hospital.
- Included children aged 6 months to 9 years undergoing surgery under general anesthesia with EEG monitoring.
- Analyzed prefrontal EEGs for BS occurrence and duration; assessed delirium using the PAED scale postoperatively.
Main Results:
- A significant relationship was identified between the presence of burst suppression (BS) on EEG during general anesthesia and the development of postoperative emergence delirium (ED) in pediatric patients.
- The study also suggests potential links between BS and other adverse outcomes such as prolonged awakening and extubation challenges.
Conclusions:
- Intraoperative burst suppression (BS) on EEG is associated with postoperative awakening delirium in children.
- Findings suggest BS as a potential biomarker for predicting adverse postoperative outcomes.
- This research may inform novel preventive strategies for emergence delirium and related complications in pediatric surgical patients.
Background:
Emergence delirium (ED) in children refers to the immediate postoperative period when children experience decreased perception of their surroundings, accompanied by disorientation and altered perception. Burst suppression (BS) is recognised as periods longer than 0.50 s during which the EEG does not exceed approximately + 5.0 mV, which is an electroencephalographic state associated with profound inactivation of the brain. Our primary objective was to determine the association between BS on electroencephalogram (EEG) under general anaesthesia with postoperative wake-up delirium and multiple adverse outcomes, such as prolonged awakening and extubation.
Methods:
In this prospective, observational cohort study at Beijing Children's Hospital, Capital Medical University, Beijing, China, children aged 6 months to 9 years who underwent surgery under general anaesthesia and underwent EEG monitoring between January 2022 and January 2023 were included. Patients' prefrontal EEGs were recorded intraoperatively as well as analysed for the occurrence and duration of BS and scored postoperatively for delirium by the PAED scale, with a score of no less than 10 considered as having developed wake-up delirium.
Discussion:
This study identified a relationship between EEG BS and postoperative awakening delirium under general anaesthesia in children and provides a novel preventive strategy for postoperative awakening delirium and multiple adverse outcomes in paediatric patients.
Trial Registration:
Chinese Clinical Trial Registry, ChiCTR2200055256. Registered on January 5, 2022.
