Abstract：
Emergence delirium is a complication of pediatric anesthesia during the early recovery period. Children undergoing ear, nose, and throat surgery are at high risk. The Pediatric Assessment of Emergence Delirium (PAED) scale is used for diagnosis and founded to specify the degree of emergence delirium. However, there is no consensus regarding a threshold value for emergence delirium diagnosis. Homeostasis-guided pediatric general anesthesia aims to maintain physiological parameters within normal ranges. In this prospective, observational study we evaluated the incidence of emergence delirium in children undergoing elective ear, nose, and throat surgery under standardized homeostasis-guided general anesthesia. Secondarily, we identified risk factors associated with an increased PAED score.
In children aged 0-6 years, we collected data from standard monitoring, depth of anesthesia, and preoperative glucose and ketone body levels. These variables were studied as risk or protective factors for increased PAED >0 scores using multivariate logistic regression.
Of the 105 children analyzed, only five children (4.7%) had emergence delirium according to a threshold PAED score ≥10, while 37 children (35%) had PAED scores >0. Statistical analysis of the PAED outcome identified two significant positive associations with pain (P<0.001) and preoperative blood glucose levels (P=0.006) and one negative association with preoperative ketone body levels (P<0.001).
Our cohort observed a lower incidence of emergence delirium than in the literature. Higher pain intensity and lower blood glucose levels were risk factors for PAED > 0, whereas preoperative ketone body levels were protective.
In children aged 0-6 years, we collected data from standard monitoring, depth of anesthesia, and preoperative glucose and ketone body levels. These variables were studied as risk or protective factors for increased PAED >0 scores using multivariate logistic regression.
Of the 105 children analyzed, only five children (4.7%) had emergence delirium according to a threshold PAED score ≥10, while 37 children (35%) had PAED scores >0. Statistical analysis of the PAED outcome identified two significant positive associations with pain (P<0.001) and preoperative blood glucose levels (P=0.006) and one negative association with preoperative ketone body levels (P<0.001).
Our cohort observed a lower incidence of emergence delirium than in the literature. Higher pain intensity and lower blood glucose levels were risk factors for PAED > 0, whereas preoperative ketone body levels were protective.
摘要：
背景：出现谵妄是小儿麻醉早期恢复期的并发症。儿童接受耳朵，鼻子,喉咙手术风险很高。出现谵妄的儿科评估（PAED）量表用于诊断，并用于指定出现谵妄的程度。然而,对于出现谵妄的诊断阈值尚无共识.稳态引导的小儿全身麻醉旨在将生理参数维持在正常范围内。在这个前景中，观察性研究我们评估了儿童择期耳部出现谵妄的发生率，鼻子,和标准稳态引导全身麻醉下的咽喉手术。其次，我们确定了与PAED评分升高相关的危险因素.
方法：在0-6岁的儿童中，我们从标准监测中收集数据，麻醉深度,术前葡萄糖和酮体水平。使用多变量逻辑回归将这些变量作为PAED>0评分增加的风险或保护因素进行研究。
结果：在分析的105名儿童中，根据阈值PAED评分≥10,只有5名儿童(4.7%)出现谵妄,而37名儿童(35%)的PAED评分>0.对PAED结果的统计分析发现，疼痛（P<0.001）和术前血糖水平（P=0.006）有两个显着正相关，而术前酮体水平则有一个负相关（P<0.001）。
结论：我们的队列观察到出现谵妄的发生率低于文献。较高的疼痛强度和较低的血糖水平是PAED>0的危险因素，而术前酮体水平是保护性的。
方法：在0-6岁的儿童中，我们从标准监测中收集数据，麻醉深度,术前葡萄糖和酮体水平。使用多变量逻辑回归将这些变量作为PAED>0评分增加的风险或保护因素进行研究。
结果：在分析的105名儿童中，根据阈值PAED评分≥10,只有5名儿童(4.7%)出现谵妄,而37名儿童(35%)的PAED评分>0.对PAED结果的统计分析发现，疼痛（P<0.001）和术前血糖水平（P=0.006）有两个显着正相关，而术前酮体水平则有一个负相关（P<0.001）。
结论：我们的队列观察到出现谵妄的发生率低于文献。较高的疼痛强度和较低的血糖水平是PAED>0的危险因素，而术前酮体水平是保护性的。
