AUTHOR=Li Lijing , Gao Zhengzheng , Zhang Jianmin , Zhang Fuzhou , Wang Fang , Wang Xiaoxue , Li Gan 

TITLE=Reduced regional cerebral oxygen saturation increases risk for emergence delirium in pediatric patients

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1117455

DOI=10.3389/fped.2023.1117455

ISSN=2296-2360

ABSTRACT=<sec><title>Objectives</title><p>To assess whether decreased regional cerebral oxygen saturation (rScO<sub>2</sub>) is associated with the emergence delirium (ED) following general anesthesia in the pediatric population.</p></sec><sec><title>Methods</title><p>A retrospective observational cohort study was conducted on 113 children (ASA I–III) aged 2–14 years who underwent selective surgery under general anesthesia between 2022-01 and 2022-04. Intraoperatively, the rScO<sub>2</sub> was monitored using a cerebral oximeter. The Pediatric Anesthesia Emergence Delirium (PAED) score was used to evaluate the patients for ED.</p></sec><sec><title>Results</title><p>The incidence of ED was 31%. Low rScO<sub>2</sub> was reported in 41.6% of patients, who had a higher incidence of ED (<italic>P</italic> &lt; 0.001) than those who did not experience desaturation. Logistic regression analysis revealed that decreased rScO<sub>2</sub> was significantly associated with incident ED events [odds ratio (OR), 10.77; 95% confidence interval, 3.31–35.05]. Children under 3 years of age had a higher incidence of ED after rScO<sub>2</sub> desaturation during anesthesia compared to older children (OR, 14.17 vs. 4.64).</p></sec><sec><title>Conclusion</title><p>Intraoperative rScO<sub>2</sub> desaturation significantly increased the incidence of ED following general anesthesia. Monitoring should be enhanced to improve the oxygen balance in vital organs to improve the quality and safety of anesthesia.</p></sec>