Paediatric Anesthesia Emergence Delirium
Conditions
Brief summary
The goal of this study is to determine the incidence and characteristics of Emergence Delirium (ED) in children aged 0 - 13 undergoing general anesthesia and being taken care of at the paediatric PACU of the Charité Campus Virchow-Clinic. Therefore the Paediatric Anesthesia Emergence Delirium Scale (PAED) is used. In order to measure the patient's pain level, age-appropriate pain scales (CHIPPS or FPS-R) are applied. Risk factors for the occurrence of ED are to be determined and therapeutic approaches in case of an occurring ED are to be evaluated. Finally the future implementation of ED-monitoring in the PACU is to be prepared.
Detailed description
Emergence Delirium is a widely known phenomenon during the recovery phase after general anesthesia in children. In spite of the existence of a vast number of studies dealing with this topic and even after the development of a validated measurement tool for ED (PAED-Scale, Sikich et al. 2004), data regarding incidence, risk factors and treatment of ED vary considerably. This study seeks to determine the actual incidence and characteristics of Emergence Delirium (ED) in children at the paediatric PACU of the Charité Campus Virchow-Clinic. Therefore the PAED-Scale is applied in a large population of children aged 0 - 13 years undergoing general anesthesia. In addition a clinical evaluation regarding the presence of ED is conducted by the PACU nurses on the basis of their clinical experience. In order to preserve the possibility of minimizing the influence of postoperative pain, which has been identified as a confounding variable in the measurement of ED, an age-appropriate pain score is measured simultaneously with each PAED-Score. The Children's and Infants Postoperative Pain Scale (CHIPPS) (Büttner, 1998) is used for children aged 0 - 4 years. The Faces Pain Scale-Revised (FPS-R) (Hicks et al. 2001) is used for older children. Besides the study aims to identify possible factors that are associated with a higher incidence of ED. Therefore perioperative data (anesthetic and analgetic agents, duration of anesthesia, premedication, volume therapy etc.) is obtained. In case of the occurrence of ED additional data (duration of ED, treatment of ED) is collected. All data is collected by using a questionnaire that is completed by the anesthesists and the PACU staff.
Interventions
None listed
Sponsors
Charite University, Berlin, Germany
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 13 Years
Healthy volunteers
No
Inclusion criteria
* Children undergoing anesthesia and being taken care of at the paediatric PACU * Aged 0 - 13 years
Exclusion criteria
• None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Paediatric Anesthesia Emergence Delirium (PAED) Score | It is measured until the end of post-anesthesia care unit (PACU) stay - or for a maximum of 24 hours | (PAED) Score at four different points of time: 1. 5 - 10 minutes after awakening 2. At clinical signs of ED (only if applicable) 3. After ED therapy (only if applicable) 4. At discharge from the PACU Age-appropriate pain score simultaneously with each PAED Score * Age 0 - 4: Children's and Infants Postoperative Pain Scale (CHIPPS) * Age 5 - 13: Faces Pain Scale-Revised (FPS-R) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Induction of anesthesia (anesthetic agents) | At time of surgery | — |
| Maintenance of anesthesia (anesthetic agents) | At time of surgery | — |
| Analgesic agents | It is measured until the end of post-anesthesia care unit (PACU) stay - or for a maximum of 24 hours | — |
| Fluid balance | At time of surgery | Fluid and volume administration and balance |
| Blood transfusions | They are measured until the end of PACU stay - or for a maximum of 5 days | — |
| Duration of stay in the PACU | Period of PACU stay | — |
| Duration of Emergence Delirium | It is measured until the end of PACU stay - or for a maximum of 5 days | — |
| Pharmacological treatment of Emergence Delirium | It is measured until the end of post-anesthesia care unit (PACU) stay - or for a maximum of 24 hours | — |
| Non-pharmacological treatment of Emergence Delirium | It is measured until the end of post-anesthesia care unit (PACU) stay - or for a maximum of 24 hours | — |
| Pain scores | It is measured until the end of post-anesthesia care unit (PACU) stay - or for a maximum of 24 hours | Age 0 - 4: Children's and Infants Postoperative Pain Scale (CHIPPS) ◦Age 5 - 13: Faces Pain Scale-Revised (FPS-R) |
| Anesthesia | At time of surgery | General Anesthesia or general anesthesia combined with regional anesthesia |
| Operation procedure | At time of surgery | Kind of surgical procedure |
| Duration of anesthesia | At time of surgery | — |
Other
| Measure | Time frame |
|---|---|
| Height | At the beginning of the investigation |
| Weight | At the beginning of the investigation |
| ASA-Classification | At the beginning of the investigation |
| Admission diagnosis | At the beginning of the investigation |
| Comorbidities | At the beginning of the investigation |
| Long-term medication | At the beginning of the investigation |
| Premedication | At the beginning of the investigation |
| PONV prophylaxis | At the beginning of the investigation |
| Gender | At the beginning of the investigation |
| Age | At the beginning of the investigation |
Countries
Germany
Outcome results
None listed