Document Detail

Emergence delirium in children: a comparison of sevoflurane and desflurane anesthesia using the Paediatric Anesthesia Emergence Delirium scale.
MedLine Citation:
PMID:  23043512     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES/AIM: This randomized control trial was designed to evaluate the incidence of emergence delirium (ED) in preschool children receiving sevoflurane or desflurane anesthesia combined with an effective caudal block.
BACKGROUND: While ED has been described in children receiving sevoflurane or desflurane anesthesia, a direct comparison between the two agents using a validated ED assessment tool has not been reported previously.
METHODS/MATERIALS: Two hundred and sixty preschool children scheduled for elective sub-umbilical surgery were randomized to receive sevoflurane or desflurane anesthesia combined with a caudal block. ED was defined as a Paediatric Anesthesia Emergence Delirium scale (PAED) ≥ 10 points. A delirium-specific score (ED I) was calculated from the first three items of the PAED score (eye contact, purposeful actions, awareness of the surroundings) and a nonspecific score (ED II) from the last two items on the PAED score (restlessness and inconsolability) to test the hypothesis that some items of the PAED scale may better reflect clinical ED than others.
RESULTS: Thirty-one (25%) children in each group demonstrated ED after awakening with ED being of shorter duration in the desflurane group than the sevoflurane group. An ED I score of nine points had a sensitivity of 0.93 and a specificity of 0.94 for ED. An ED II score of five points had a sensitivity of 0.34 and specificity of 0.95 for ED.
CONCLUSION: Sevoflurane and desflurane anesthesia were associated with similar incidences of ED in children undergoing sub-umbilical surgery and receiving effective regional anesthesia. High scores on the first three items of the PAED scale were highly correlated with ED. The items restlessness and inconsolability had lower sensitivity for the diagnosis of ED.
Bruno G Locatelli; Pablo M Ingelmo; Sahillioğlu Emre; Veronica Meroni; Carmelo Minardi; Geoff Frawley; Alberto Benigni; Salvatore Di Marco; Angelica Spotti; Ilaria Busi; Valter Sonzogni
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-10-09
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  23     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-08-30     Revised Date:  2014-11-13    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  301-8     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
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MeSH Terms
Anesthesia Recovery Period*
Anesthesia, Caudal
Anesthetics, Inhalation*
Carbon Dioxide / metabolism
Child, Preschool
Delirium / chemically induced*,  psychology
Endpoint Determination
Isoflurane / analogs & derivatives*
Kaplan-Meier Estimate
Laryngeal Masks
Lung / metabolism
Methyl Ethers*
Nerve Block
Preanesthetic Medication
Regression Analysis
Sample Size
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 142M471B3J/Carbon Dioxide; 28523-86-6/sevoflurane; 57041-67-5/desflurane; CYS9AKD70P/Isoflurane
Comment In:
Paediatr Anaesth. 2014 May;24(5):547   [PMID:  24708454 ]
Paediatr Anaesth. 2014 Sep;24(9):1014-5   [PMID:  25092448 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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