Incidence and risk factors for emergence delirium in children undergoing surgery under general anaesthesia - A...

Area of Science:

• Pediatric Anesthesiology
• Postoperative Care
• Child Psychology

Background:

• Emergence delirium (ED) is a frequent complication following pediatric general anesthesia (GA), with reported incidence ranging widely from 2% to 80%.
• Understanding the specific incidence and risk factors for ED in children is crucial for improving postoperative outcomes and patient safety.

Purpose of the Study:

• To determine the incidence of emergence delirium (ED) in children undergoing surgery under general anesthesia (GA).
• To identify significant risk factors associated with the development of ED in this pediatric population.

Main Methods:

• An observational, prospective study involving 336 children aged 2-13 years undergoing surgery under GA.
• Preoperative anxiety, demographics, and postoperative behavioral assessments using the Pediatric Anesthesia Emergence Delirium (PAED) scale, Watcha scale, and Face, Legs, Activity, Cry, Consolability (FLACC) scale were employed.
• Multivariate linear regression analysis was used to explore associations between potential risk factors and ED, with ED defined by specific PAED and Watcha scale scores.

Main Results:

• The incidence of ED was found to be 3.87% (95% CI: 1.80, 5.94).
• Significant associations were identified between ED and male sex, severe preoperative anxiety, and postoperative pain at 0 and 10 minutes after surgery.
• Both the PAED and Watcha scales demonstrated excellent accuracy (AUROC 0.99) in detecting ED.

Conclusions:

• The incidence of ED in this cohort was 3.87%.
• Male sex, severe preoperative anxiety, and postoperative pain are significant risk factors for ED in children.
• The PAED and Watcha scales are highly effective tools for identifying ED in pediatric patients.