Emergence delirium in children is not related to intraoperative burst suppression – prospective, observational electrography study

• Main Authors: Susanne Koch, Anna-Maria Stegherr, Leopold Rupp, Jochen Kruppa, Christine Prager, Sylvia Kramer, Astrid Fahlenkamp, Claudia Spies
• Format: Article
• Language: English
• Published: BMC 2019-08-01
• Series: BMC Anesthesiology
• Subjects: Burst suppression; Paediatrics: pre-operative anxiety; EEG: high dose opiates
• Online Access: http://link.springer.com/article/10.1186/s12871-019-0819-2

Abstract Background Emergence-delirium is the most frequent brain dysfunction in children recovering from general anaesthesia, though the pathophysiological background remains unclear. The presented study analysed an association between emergence delirium and intraoperative Burst Suppression activity in the electroencephalogram, a period of very deep hypnosis during general anaesthesia. Methods In this prospective, observational cohort study at the Charité - university hospital in Berlin / Germany children aged 0.5 to 8 years, undergoing planned surgery, were included between September 2015 and February 2017. Intraoperative bi-frontal electroencephalograms were recorded. Occurrence and duration of Burst Suppression periods were visually analysed. Emergence delirium was assessed using the Pediatric Assessment of Emergence Delirium Score. Results From 97 children being analysed within this study, 40 children developed emergence delirium, and 57 children did not. Overall 52% of the children displayed intraoperative Burst Suppression periods; however, occurrence and duration of Burst Suppression (Emergence delirium group 55% / 261 + 462 s vs. Non-emergence delirium group 49% / 318 + 531 s) did not differ significantly between both groups. Conclusions Our data reveal no correlation between the occurrence and duration of intraoperative Burst Suppression activity and the incidence of emergence delirium. Burst Suppression occurrence is frequent; however, it does not seem to have an unfavourable impact on cerebral function at emergence from general anaesthesia in children. Trail registration NCT02481999, June 25, 2015.