Related Experiment Video
Updated: Aug 14, 2026
09:36
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
EEG-Guided Sevoflurane Anesthesia and Emergence Delirium in Children: A Randomized Controlled Trial
Ozlem Kocaturk1, Sultan Keles2
1Division of Anesthesiology, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydin Adnan Menderes University, Aydin, Turkey.
Paediatric Anaesthesia
|August 13, 2026
Summary
Electroencephalogram (EEG)-guided anesthesia reduced emergence delirium (ED) and sevoflurane use in children undergoing dental procedures. This approach offers a promising alternative to standard anesthetic monitoring for improved pediatric patient outcomes.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Pediatric Anesthesia
- Neurophysiology
Background:
- Minimum alveolar concentration (MAC) is standard for inhalational agent dosing in pediatric anesthesia but may not precisely gauge anesthetic depth.
- Electroencephalogram (EEG)-guided anesthesia, while beneficial in adults, is underutilized in pediatric populations.
- Emergence delirium (ED) is a common postoperative complication in children.
Purpose of the Study:
- To assess the impact of EEG-guided anesthesia using SedLine on emergence delirium (ED) in noncompliant children undergoing dental procedures.
- To evaluate the effect of EEG-guided anesthesia on sevoflurane dosage in pediatric patients.
- To compare EEG-guided anesthesia with standard MAC-guided anesthesia in terms of ED incidence and anesthetic agent consumption.
Main Methods:
- A prospective, randomized controlled trial involving 100 children (4-10 years) undergoing general anesthesia for dental procedures.
- Participants were randomized to either standard anesthesia (MAC-guided) or EEG-guided anesthesia (SedLine, targeting PSI 25-50 and SEF 10-15 Hz).
- Primary outcome was ED incidence (assessed by PAEDS); secondary outcomes included sevoflurane dose, pain, and recovery metrics.
Main Results:
- The EEG-guided anesthesia group showed significantly lower Pediatric Anesthesia Emergence Delirium Scale (PAEDS) scores postoperatively.
- Incidence of ED was significantly reduced in the EEG-guided group upon arrival in the recovery room (17% vs. 43%) and at 10 minutes postoperatively (17% vs. 37%).
- Mean end-tidal sevoflurane concentration was statistically lower in the EEG-guided group (1.88 vs. 1.98), and postoperative pain scores were also reduced.
Conclusions:
- EEG-guided anesthesia demonstrated an association with reduced emergence delirium and decreased sevoflurane consumption in pediatric dental procedures.
- The observed differences in EEG parameters were small, and potential confounding by postoperative pain necessitates cautious interpretation.
- Specific EEG targets predictive of emergence delirium could not be identified within the study's applied ranges.
Related Concept Videos
01:20Inhalational Anesthetics: Overview
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.