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Emergence delirium in children following strabismus surgery is a distressing and potentially dangerous condition and is likely attributable to visual disturbances, pain, and anesthetic gases. We explored whether a single intraoperative dose of methadone could reduce emergence delirium. Our study was an institutional review board-approved prospective, controlled, before-and-after investigation. Inclusion criteria were age <18 years and American Society of Anesthesiologists (ASA) classification 1 or 2. Patients were excluded for obesity, documented sleep apnea, significant neurologic disease, or inpatient status. Control group patients were recruited sequentially, and the anesthetic was performed per preference. The study group was recruited similarly and received an intravenous dose of methadone 0.15 mg/kg at induction. The primary outcome was peak score on the Pediatric Anesthesia Emergence Delirium (PAED) scale. Secondary outcomes included time to anesthetic emergence, postoperative pain scores, postanesthesia care unit (PACU) length of stay, and postdischarge respiratory complications. Forty-nine control group and 55 study group patients were recruited. No significant differences were found between groups for age, sex, weight, ASA classification, or duration of surgery. The control group received more preoperative midazolam, intraoperative fentanyl, and intraoperative ketorolac. Compared to the control group, the study group had 42% and 85% reductions in peak and severe PAED scale scores, respectively, in the PACU and required less rescue pain medications. Anesthetic emergence time and length of stay were not different between the groups. No significant postoperative complications occurred. Emergence delirium following outpatient pediatric strabismus surgery was substantially mitigated by the use of intraoperative methadone without affecting PACU throughput. No significant complications occurred. Further study is warranted to corroborate routine use of this drug for emergence delirium.
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http://dx.doi.org/10.31486/toj.23.0126 | DOI Listing |
Korean J Anesthesiol
December 2024
Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China.
Background: Delirium in the post-anesthesia care unit (PACU) may be associated with worse outcomes in children with moyamoya disease (MMD). This retrospective study aimed to describe the prevalence of PACU delirium in children with MMD and investigate its risk factors.
Methods: Patients with MMD aged < 15 years who underwent indirect revascularization between January 2014 and October 2023 were included in this study.
Turk J Anaesthesiol Reanim
December 2024
All India Institute of Medical Sciences, Department of Anaesthesiology, Pain Medicine and Critical Care, New Delhi, India.
Objective: The neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are indicators of postoperative inflammatory response. Low-dose ketamine has analgesic and anti-inflammatory properties. Inguinal hernia surgery is associated with a higher incidence of chronic pain.
View Article and Find Full Text PDFPLoS One
December 2024
Department of Nursing, Andong National University, Andong, South Korea.
In this study, we aimed to explore the relationships between knowledge of emergence delirium (ED) and nursing stress, practice, confidence, and performance levels, as well as to identify factors influencing the performance of recovery room nurses. We conducted a cross-sectional study with 135 recovery room nurses at a general hospital in South Korea. The nurses completed a questionnaire from April 12 to April 25, 2023.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu, 241001, China.
Paediatr Anaesth
November 2024
Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
Background: Emergence delirium is a well-known and common problem in children recovering from anesthesia. The five-item Pediatric Anesthesia Emergence Delirium scale is one of the most commonly used instruments for assessing this condition, but the scale has been questioned regarding its latent structure, i.e.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!