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@article{2355337, author = {Frelich, Michal and Lecbychova, Karolina and Vodicka, Vojtech and Ekrtova, Tereza and Sklienka, Peter and Jor, Ondrej and Strakova, Hana and Bilena, Marketa and Formánek, Martin and Bursa, Filip}, article_location = {ISSY-LES-MOULINEAUX}, article_number = {1}, doi = {http://dx.doi.org/10.1016/j.accpm.2023.101318}, keywords = {Emergence delirium; PAED score; Postoperative outcomes; Postoperative recovery; Children}, language = {eng}, issn = {2352-5568}, journal = {ANAESTHESIA CRITICAL CARE & PAIN MEDICINE}, title = {Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial}, url = {https://www.sciencedirect.com/science/article/pii/S2352556823001261?via%3Dihub}, volume = {43}, year = {2024} }
TY - JOUR ID - 2355337 AU - Frelich, Michal - Lecbychova, Karolina - Vodicka, Vojtech - Ekrtova, Tereza - Sklienka, Peter - Jor, Ondrej - Strakova, Hana - Bilena, Marketa - Formánek, Martin - Bursa, Filip PY - 2024 TI - Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial JF - ANAESTHESIA CRITICAL CARE & PAIN MEDICINE VL - 43 IS - 1 SP - 1-6 EP - 1-6 PB - ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER SN - 23525568 KW - Emergence delirium KW - PAED score KW - Postoperative outcomes KW - Postoperative recovery KW - Children UR - https://www.sciencedirect.com/science/article/pii/S2352556823001261?via%3Dihub N2 - Objective: Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by a perception and psychomotor disorder, with a negative impact on postoperative recovery. As the use of inhalation anesthesia is associated with a higher incidence of ED, we investigated whether titrating the depth of general anesthesia with BIS monitor can reduce the incidence of ED.Design: Randomized, prospective, and double-blind. Setting: Patients undergoing endoscopic adenoidectomy under general anesthesia according to a uniform protocol.Patients: A total of 163 patients of both sexes aged 3-8 years were enrolled over 18 months. Interventions: Immediately after the induction of general anesthesia, a bispectral index (BIS) electrode was placed on the patient's forehead. In the study group, the depth of general anesthesia was monitored with the aim of achieving BIS values of 40-60. In the control group, the dose of sevoflurane was determined by the anaesthesiologist based on MAC (minimum alveolar concentration) and the end-tidal concentration.Measurements: The primary objective was to compare the occurrence of ED during the PACU (postanesthesia care unit) stay in both arms of the study. The secondary objective was to determine the PAED score at 10 and 30 min in the PACU and the need for rescue treatment of ED.Main results: 86 children were randomized in the intervention group and 77 children in the control group. During the entire PACU stay, 23.3% (38/163) of patients developed ED with PAED score >10: 35.1% (27/77) in the control group and 12.8% (11/86) in the intervention group (p = 0.001). Lower PAED scores were also found in the intervention group at 10 (p < 0.001) and 30 (p < 0.001) minutes compared to the control group. The need for rescue treatment did not differ between groups (p = 0.067).Conclusion: Individualization of the depth of general anesthesia with BIS monitoring is an effective method of preventing ED in children. ER -
FRELICH, Michal, Karolina LECBYCHOVA, Vojtech VODICKA, Tereza EKRTOVA, Peter SKLIENKA, Ondrej JOR, Hana STRAKOVA, Marketa BILENA, Martin FORMÁNEK a Filip BURSA. Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial. \textit{ANAESTHESIA CRITICAL CARE \&{} PAIN MEDICINE}. ISSY-LES-MOULINEAUX: ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER, 2024, roč.~43, č.~1, s.~1-6. ISSN~2352-5568. Dostupné z: https://dx.doi.org/10.1016/j.accpm.2023.101318.
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