Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients
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 th...
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-021-01507-2 |
| _version_ | 1818433935889137664 |
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| author | Wangseok Do Hyo-Sung Kim Seung Ha Kim Hyunjong Kang Dowon Lee Jiseok Baik Hyeon Jeong Lee Jeong-Min Hong |
| author_facet | Wangseok Do Hyo-Sung Kim Seung Ha Kim Hyunjong Kang Dowon Lee Jiseok Baik Hyeon Jeong Lee Jeong-Min Hong |
| author_sort | Wangseok Do |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-14T16:29:00Z |
| format | Article |
| id | doaj.art-36c1834e2ab540cabeed0141695a9eea |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-14T16:29:00Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj.art-36c1834e2ab540cabeed0141695a9eea2022-12-21T22:54:38ZengBMCBMC Anesthesiology1471-22532021-11-012111710.1186/s12871-021-01507-2Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patientsWangseok Do0Hyo-Sung Kim1Seung Ha Kim2Hyunjong Kang3Dowon Lee4Jiseok Baik5Hyeon Jeong Lee6Jeong-Min Hong7Biomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalBiomedical Research Institute, Pusan National University HospitalAbstract 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.https://doi.org/10.1186/s12871-021-01507-2Emergence deliriumPreoperative sleep qualityPediatricsStrabismus surgery |
| spellingShingle | Wangseok Do Hyo-Sung Kim Seung Ha Kim Hyunjong Kang Dowon Lee Jiseok Baik Hyeon Jeong Lee Jeong-Min Hong Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients BMC Anesthesiology Emergence delirium Preoperative sleep quality Pediatrics Strabismus surgery |
| title | Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients |
| title_full | Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients |
| title_fullStr | Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients |
| title_full_unstemmed | Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients |
| title_short | Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients |
| title_sort | sleep quality and emergence delirium in children undergoing strabismus surgery a comparison between preschool and school age patients |
| topic | Emergence delirium Preoperative sleep quality Pediatrics Strabismus surgery |
| url | https://doi.org/10.1186/s12871-021-01507-2 |
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