AI Article Synopsis

  • Emergence agitation, or emergence delirium, is a significant issue in pediatric anesthesia, especially affecting children under 6, with reported cases in about 30% of them.
  • The study aims to compare the incidence of pediatric anesthesia emergence delirium (PAED) using standard sevoflurane anesthesia versus EEG-guided anesthesia to minimize volatile anesthetic exposure.
  • The hypothesis is that utilizing EEG monitoring can reduce sevoflurane exposure without compromising surgical effectiveness, potentially lowering the occurrence of PAED.

Article Abstract

Background: Emergence agitation or emergence delirium is a common complication of unknown etiology in pediatric anesthesia. Pediatric anesthesia emergence delirium (PAED) has been reported most commonly in younger children and may occur in about 30% of children up to 5-6 years old. Exposure to anesthetic agents may contribute to PAED, and we hypothesized that a management strategy to minimize exposure to volatile anesthetics may reduce PAED. Electroencephalography (EEG) signatures captured and displayed by brain function monitors during anesthesia change with concentration of sevoflurane and level of unconsciousness, and these EEG signatures may be used to inform titration of anesthetics.

Methods: A single-center, parallel-group, two-arm, superiority trial with a 1:1 allocation ratio will be performed to compare the incidence of PAED following standard sevoflurane anesthesia (maintained at 1.0MAC) and EEG-guided anesthesia (minimum concentration to sustain surgical anesthesia as determined by monitoring of EEG signatures). Participants between 1 and 6 years of age undergoing surgical procedures involving minimal postoperative pain will be randomly assigned to receive standard (n = 90) or EEG-guided (n = 90) anesthesia. PAED score will be assessed by a blinded observer in the PACU on arrival and after 5, 10, 15, and 30 min.

Discussion: Anesthesia management with proactive use of brain function monitoring is expected to reduce exposure to sevoflurane without compromising surgical anesthesia. We expect this reduced exposure should help prevent PAED. Routinely administering what may be considered standard levels of anesthetic such as 1.0 MAC sevoflurane may be excessive and potentially associated with unfavorable sequelae such as PAED.

Trial Registration: Japan Registry of Clinical Trials (jRCT) jRCTs032210248. Prospectively registered on 17 August 2021.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10655373PMC
http://dx.doi.org/10.1186/s13063-023-07785-0DOI Listing

Publication Analysis

Top Keywords

pediatric anesthesia
12
emergence delirium
12
brain function
12
eeg signatures
12
anesthesia
11
anesthesia emergence
8
sevoflurane anesthesia
8
function monitoring
8
eeg-guided anesthesia
8
surgical anesthesia
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!