Correlation Analysis Between Real-Time Cerebral State Parameters and Emergence Agitation in Children Undergoing...

To analyse the correlation between real-time cerebral state index (CSI) and postoperative emergence agitation (EA) in children undergoing surgery for decayed teeth during recovery from general anaesthesia, and to explore the feasibility of CSI in predicting EA during perioperative care.

A retrospective case-control study was performed for paediatric patients who underwent radical surgery for decayed teeth under general anaesthesia at the Stomatology Outpatient Department of the Children's Hospital of Shanxi from January 2022 to December 2022. According to the presence or absence of EA in children during recovery from general anaesthesia, the enrolled patients were divided into two groups: the agitation group (Group A) and the non-agitation group (Group NA). All paediatric patients were monitored for CSI using a combined-type multifunctional monitor of HXD-I Multi-parameter Monitor after the induction of tracheal intubation under intravenous anaesthesia.

There were 16 cases (40%) of EA among the affected children. At post-extubation (T6), the subcortical excitability index (SCEi) (95[71-99] vs 46[15-78]), cortical excitability index (CEi) (45[34-77] vs 32[10-49]) and anxiety index (ANXi) (49[41-58] vs 41[30-49]) of Group A were significantly higher than those of Group NA, while memory index (Mi) (10[8-14] vs 12[9-14]) was smaller than in the latter group, with statistically significant differences between groups (P<0.05). Additionally, as shown in the receiver operating characteristic curve, at T6, the area under the curve of SCEi, CEi, ANXi and Mi in predicting EA separately was 0.762, 0.771, 0.709 and 0.711, with sensitivity of 82.9%, 87.0%, 84.3% and 63.6%, and specificity of 70.4%, 43.5%, 46.8% and 77.2%, respectively.

Post-extubation SCEi, CEi, ANXi and Mi were significantly associated with EA occurrence in children undergoing decayed tooth surgery under general anaesthesia, with SCEi and ANXi showing relatively better predictive performance.