Frontal electroencephalogram activity during emergence from general anaesthesia in children with and without emergence delirium

医学 置信区间 谵妄 脑电图 麻醉 相对风险 七氟醚 全身麻醉 接收机工作特性 前瞻性队列研究 发作性谵妄 儿科 内科学 精神科
作者
Jong Hae Kim,Hyung‐Chul Lee,Sung Hye Byun,Hyunyoung Lim,Minkyu Lee,Yoojin Choung,Eugene Kim
出处
期刊:BJA: British Journal of Anaesthesia [Elsevier BV]
卷期号:126 (1): 293-303 被引量:21
标识
DOI:10.1016/j.bja.2020.07.060
摘要

BackgroundEmergence delirium (ED) in children after general anaesthesia causes significant distress in patients, their family members, and clinicians; however, electroencephalogram (EEG) markers predicting ED have not been fully investigated.MethodsThis prospective, single-centre observational study enrolled children aged 2–10 yr old under sevoflurane anaesthesia. ED was assessed according to Diagnostic and Statistical Manual of Mental Disorders (DSM) IV or 5 criteria. The relative power of low-frequency (delta and theta) and high-frequency (alpha and beta) EEG waves during the emergence period was compared between the children with and without ED. The linear relationships between the relative power and peak Paediatric Assessment of Emergence Delirium (PAED) score were investigated.ResultsAmong the 60 patients, 22 developed ED (ED group), whereas the other 38 did not (non-ED group). The relative power of the delta wave was higher (mean [standard deviation], 0.579 [0.083] vs 0.453 [0.090], respectively, P<0.001) in the ED group, whereas that of the alpha and beta waves was lower in the ED group, than in the non-ED group (0.155 [0.063] vs 0.218 [0.088], P=0.005 and 0.114 [0.069] vs 0.186 [0.070], P<0.001, respectively). The areas under the receiver operating characteristic curves of the relative power of the delta wave, low-to-high frequency power ratio, and delta-to-alpha ratio were 0.837 (95% confidence interval, 0.737–0.938), 0.835 (0.735–0.934), and 0.768 (0.649–0.887), respectively. The relative power of the delta wave and the two ratios had a positive linear relationship with the peak PAED scores.ConclusionsPaediatric patients developing ED have increased low-frequency (delta) frontal EEG activity with reduced high-frequency (alpha and beta) activity during emergence from general anaesthesia.Clinical trial registrationNCT03797274.
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