Pediatric anesthesia & critical care
Association between emergence delirium and brain status parameters in children undergoing general anesthesia: A prospective observational study
Authors' conclusion
Both anxiety index and comfort index derived from electroencephalogram wavelet analysis were associated with emergence delirium in pediatric patients undergoing general anesthesia for dental surgery.
Study context
- Population
- Children aged 3–6 years undergoing dental surgery under GA116 analysed
- Participants
- 130 children
- Exposure
- EEG-derived brain status parameters for predicting emergence delirium
- Outcome
- Ability of brain status parameters to predict emergence delirium (Pediatric Anesthesia Emergence Delirium scale; AUC)
Methodological detailsdiagnostic accuracy (ROC analysis)
- Diagnostic accuracy (ROC analysis)
Main finding
As reported in the abstract
Prediction of emergence delirium
| Group | AUC | Sensitivity | Specificity | Best cutoff |
|---|---|---|---|---|
| Anxiety index | 0.84 [0.75-0.93] (p < .001) | 73.0% | 89.9% | 46.5 |
| Comfort index | 0.89 [0.81-0.96] (p < .001) | 91.9% | 83.5% | 68.5 |
| Wavelet index | 0.43 [0.31-0.35] (p = .27) | |||
| Pain threshold index | 0.49 [0.37-0.62] (p = .73) |
AUC
Anxiety index0.84 [0.75-0.93] (p < .001)
Comfort index0.89 [0.81-0.96] (p < .001)
Wavelet index0.43 [0.31-0.35] (p = .27)
Pain threshold index0.49 [0.37-0.62] (p = .73)
Sensitivity
Anxiety index73.0%
Comfort index91.9%
Wavelet index— not stated in the abstract
Pain threshold index— not stated in the abstract
Specificity
Anxiety index89.9%
Comfort index83.5%
Wavelet index— not stated in the abstract
Pain threshold index— not stated in the abstract
Best cutoff
Anxiety index46.5
Comfort index68.5
Wavelet index— not stated in the abstract
Pain threshold index— not stated in the abstract
Observational data: associations, not effects.
Further findings
Incidence of emergence delirium (PAED score >10)
- Patients with emergence delirium
- 37 (31.90%)
Brain status parameters, T1 (end of anaesthetic administration) vs T4 (response to verbal stimulation)
- Wavelet index, T1 → T4 (mean ± SD)
- 59.5 ± 6.2 → 67.4 ± 9.4
- Pain threshold index, T1 → T4
- 61.7 ± 5.3 → 73.2 ± 9.1
- Anxiety index, T1 → T4
- 9.2 ± 2.5 → 38.6 ± 11.2
- Comfort index, T1 → T4
- 21.6 ± 8.7 → 66.1 ± 16.5
- Increased significantly, p < .001
Original publication
Association between emergence delirium and brain status parameters in children undergoing general anesthesia: A prospective observational study. Paediatr Anaesth. Published 3 October 2023. doi:10.
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