Correlation between duration of preoperative fasting and emergence delirium in pediatric patients undergoing ophthalmic examination under anesthesia: A prospective observational study.

Abstract

Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. In this prospective observational study, 100 children between the age group 2-6years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited. Data regarding preoperative fasting was recorded and presence of emergence delirium was assessed by the Pediatric Anesthesia Emergence Delirium (PAED) scale at 5minute interval till 30minutes from the time of leaving the operation theater. No premedication was used in any patients but parental presence was allowed in all of them. Mean (standard deviation) duration of fasting to clear liquid was 6.3 (1.7) hrs. Twenty-four children (24%) had at least 1 recorded PAED score >10 at any time point in the postoperative period. PAED scores at 15 and 25minutes were significantly correlated with duration of fasting (r2 [95% CI]=.24 [0.04, 0.41], P=.02, Pearsons's correlation and r2 [95% CI]=.23 [0.04, 0.41], P=.02, Pearsons's correlation, respectively). No correlation has been found between duration of fasting and blood glucose level (r2 [95% CI]=-.05 [-0.24, 0.15], P=.65, Pearsons's correlation) between fasting blood glucose and PAED score at any time point. Increased preoperative fasting duration may be a risk factor for postoperative emergence delirium in children undergoing ophthalmic examination under general anesthesia.