Effect of BIS-guided anesthesia on emergence delirium following
general anesthesia in children: A prospective randomized
controlled trial

J 2024

Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial

FRELICH, Michal, Karolina LECBYCHOVA, Vojtech VODICKA, Tereza EKRTOVA, Peter SKLIENKA et. al.

Basic information

Original name

Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial

Authors

FRELICH, Michal (203 Czech Republic), Karolina LECBYCHOVA (203 Czech Republic), Vojtech VODICKA (203 Czech Republic), Tereza EKRTOVA (203 Czech Republic), Peter SKLIENKA (203 Czech Republic), Ondrej JOR (203 Czech Republic), Hana STRAKOVA (203 Czech Republic), Marketa BILENA (203 Czech Republic), Martin FORMÁNEK (203 Czech Republic, belonging to the institution) and Filip BURSA (203 Czech Republic)

Edition

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE, ISSY-LES-MOULINEAUX, ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER, 2024, 2352-5568

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30223 Anaesthesiology

Country of publisher

France

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.500 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.accpm.2023.101318

UT WoS

001124655500001

Keywords in English

Emergence delirium; PAED score; Postoperative outcomes; Postoperative recovery; Children

Abstract

V originále

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.

Citovat

FRELICH, Michal, Karolina LECBYCHOVA, Vojtech VODICKA, Tereza EKRTOVA, Peter SKLIENKA, Ondrej JOR, Hana STRAKOVA, Marketa BILENA, Martin FORMÁNEK and Filip BURSA. Effect of BIS-guided anesthesia on emergence delirium following general anesthesia in children: A prospective randomized controlled trial. ANAESTHESIA CRITICAL CARE & PAIN MEDICINE. ISSY-LES-MOULINEAUX: ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER, 2024, vol. 43, No 1, p. 1-6. ISSN 2352-5568. Available from: https://dx.doi.org/10.1016/j.accpm.2023.101318.

@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 and 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, vol.~43, No~1, p.~1-6. ISSN~2352-5568. Available from: https://dx.doi.org/10.1016/j.accpm.2023.101318.

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