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Predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia at Amhara

Debas Yaregal Melesse1, Tadesse Teshale Tesema1, Zemenay Ayinie Mekonnen1

  • 1Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Frontiers in Pediatrics
|March 25, 2024
PubMed

Insights

Postoperative delirium in children undergoing general anesthesia is common in Ethiopia. Key predictors include ophthalmic surgery, corticosteroid use, and severe pain, while sedative premedication and paracetamol may be protective.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Critical Care Medicine

Background:

  • Postoperative delirium (POD) is a significant concern in pediatric patients, particularly in low- and middle-income countries.
  • Limited research exists on the extent and predictors of POD in these settings.

Purpose of the Study:

  • To identify predictors of postoperative delirium in pediatric patients undergoing general anesthesia at Tertiary Hospitals in Ethiopia.

Main Methods:

  • A multicenter, prospective follow-up study was conducted with 424 pediatric surgical patients (birth to 16 years).
  • Data were collected using patient charts and direct observation with the Cornell Assessment of Pediatric Delirium (CAPD).
  • Binary logistic regression analysis was employed to determine predictors of POD.

Main Results:

  • Postoperative delirium occurred in 160 of 404 (39.6%) pediatric patients.
  • Predictors of POD included ophthalmic surgery, corticosteroid use, anticholinergic use, severe postoperative pain, and preoperative anxiety.
  • Sedative premedication and paracetamol were found to be protective against POD.

Conclusions:

  • The incidence of POD in Ethiopian pediatric surgical patients is higher than in developed countries.
  • Ophthalmic surgery, corticosteroid use, anticholinergic medications, postoperative pain, and preoperative anxiety are significant predictors.
  • Targeted screening and management of these factors may help mitigate the impact of POD.
Abstract

Keywords:
factorsgeneral anesthesiaincidencepediatricspostoperative deliriumpredictors

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