Feasibility trial of weighted blankets as an intervention for emergence delirium in postoperative pediatric patients

Abstract Background Dexmedetomidine is widely used in the treatment of emergency delirium (ED) in pediatric patients. However, further evidence on its use in pediatric anesthesia on potential differences in the reduction of ED according to patient’s age and type of anesthesia is required. Moreover, whether dexmedetomidine influences time of discharge from the surgical area remains unclear. We evaluated whether intranasal dexmedetomidine is effective in decreasing the incidence of ED in 106 children who had anesthesia for plastic surgery undergoing general or combined anesthesia at different ages. We also assessed if this drug has an impact on time to discharge from the surgical area. Methods In total, 106 children, aged 2–10 years, were enrolled in this retrospective study. Among them, 50 have been premedicated with dexmedetomidine (dexmedetomidine group); the remaining 56 patients served as controls (control group). The incidence of ED was evaluated according to the use of dexmedetomidine premedication, age and type of anesthesia (general vs combined). The length of anesthesia and duration of staying in the surgical area were also analyzed. Results Three patients who received dexmedetomidine premedication showed ED (6%), compared with 43 patients in the control group (77%; p<0.05). This lower incidence of ED was also present when stratifying patients according to the type of anesthesia or age. No difference between the dexmedetomidine group and control group were reported in timing of discharge from surgical area.Conclusions Premedication with dexmedetomidine is associated with decreased incidence of ED without increasing timing of discharge after surgery, regardless of patients’ age or type of anesthesia. In particular, patients subjected to combined anesthesia report benefit from the use of this molecule.

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Correlation between duration of preoperative fasting and emergence delirium in pediatric patients undergoing ophthalmic examination under anesthesia: A prospective observational study

Pediatric Anesthesia ◽

10.1111/pan.13381 ◽

2018 ◽

Vol 28 (6) ◽

pp. 547-551 ◽

Cited By ~ 1

Author(s):

Puneet Khanna ◽

Kulbhushan Saini ◽

Renu Sinha ◽

Niseville Nisa ◽

Shailendra Kumar ◽

...

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

Pediatric Patients ◽

Preoperative Fasting ◽

Emergence Delirium ◽

Ophthalmic Examination

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Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients

BMC Anesthesiology ◽

10.1186/s12871-021-01507-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wangseok Do ◽

Hyo-Sung Kim ◽

Seung Ha Kim ◽

Hyunjong Kang ◽

Dowon Lee ◽

...

Keyword(s):

Sleep Quality ◽

Pediatric Patients ◽

Group Analysis ◽

Pediatric Anesthesia ◽

Strabismus Surgery ◽

Preschool Age ◽

Anesthesia Induction ◽

Emergence Delirium ◽

Scale Scores ◽

The Relationship

Abstract Background Emergence delirium (ED) is common in pediatric patients undergoing general anesthesia with sevoflurane. Preoperative sleep quality is associated with the risk factors for ED. However, research on the relationship between sleep quality and ED is limited. We aimed to investigate the relationship between ED and preoperative sleep quality in pediatric patients undergoing strabismus surgery. Methods This clinical trial included pediatric patients aged 4–12 years who underwent elective strabismus surgery. The patients and their parents were questioned about the patients’ preoperative sleep quality using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. For anesthesia induction, thiopental (5 mg/kg) and rocuronium (0.6 mg/kg) were used, and anesthesia was maintained with sevoflurane (minimum alveolar concentration, 1–1.5). After administration of a reversal drug, extubation was performed, and the patients were transferred to a post-anesthesia recovery unit. At 10 min after extubation, the degree of ED was measured using the pediatric anesthesia emergence delirium (PAED) and Watcha scale scores. Results Of the 62 enrolled patients, three pediatric patients were excluded. The overall incidence of ED was 22%. A total of 59 patients were divided into the two groups. The ED group and the non-ED group comprised 13 and 46 patients. Age, height and weight were significantly lower in the ED group than in the non-ED group. Preoperative PSQI and Watcha scale score were significantly higher in the ED group than in the non-ED group. Multivariate analysis showed that age (adjusted OR [95% CI]: 0.490 [0.290–0.828], p = 0.008) and preoperative PSQI score (adjusted OR [95% CI]: 2.149[1.224–3.771], p = 0.008) was associated with ED. In sub-group analysis, PAED scale and Watcha scale scores showed a moderate correlation with preoperative sleep quality in preschool-age patients. Conclusion In conclusion, the incidence of ED tended to be higher in younger age and poorer preoperative sleep quality in pediatric patients. In particular, the poorer sleep quality score was associated with higher incidence of ED in the preschool-age. Large-scale clinical studies and long-term follow-up studies on ED and sleep quality are required. Trial registration This study was registered with Clinicaltrials.gov (NCT03332407) at November 5th 2017.

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