Effect of Different Durations of Eye-Covering Pretreatment on Emergence Delirium after Ophthalmic Surgery in Preschool-Aged Children: A Randomized Controlled Study

Pei-Fang Dong, Dan-Ni Qiao, Hui-Lian Chen, Shui-Hua Lu, Shao-Hong Qu, Yun-Tao Wu, Di Zhao, Ting Wan, Pei-Fang Dong, Dan-Ni Qiao, Hui-Lian Chen, Shui-Hua Lu, Shao-Hong Qu, Yun-Tao Wu, Di Zhao, Ting Wan

Abstract

Background: Preoperative eye-covering training for 3 hours has been reported to effectively reduce the incidence of emergence delirium (ED) in preschool children. However, most children can only maintain the eye being covered for less than 60 min, and shortening eye-covering duration can also achieve similar clinical effects as long duration of eye-covering. This study was designed to compare the effects of 30-min and 60-min eye-covering pretreatment based on cartoon education only on preoperative anxiety, postoperative ED, and pain score after ophthalmic surgery with general anesthesia in preschool-aged children.

Methods: Preschool-aged children (3-7 years) who were diagnosed with cataract, blepharoptosis, trichiasis, strabismus, eyelid tumor, and underwent ophthalmic surgery with general anesthesia from August 2021 to January 2022 were recruited. A total of 228 patients were randomly assigned at a 1 : 1:1 ratio to receive 30-min eye covering (30-min group), 60-min eye covering (60-min group) pretreatment, or programmed education only (C group). The preoperative anxiety, postoperative emergence delirium, and pain were compared between the groups.

Results: The preoperative anxiety score, postoperative ED score, and incidence of ED in the 30-min group (n = 76) and 60-min group (n = 72) were significantly lower than those in the C group (n = 76), demonstrating a significant between-group difference (P < 0.001). However, the 30-min group and 60-min group had no significant difference in the abovementioned outcome measures (P > 0.05). Moreover, no significant difference was found in postoperative pain scores among the three groups (H = 0.274, P=0.872).

Conclusion: Both 30-min and 60-min eye-covering pretreatments significantly reduce preoperative anxiety and postoperative ED after ophthalmic surgery with general anesthesia in preschool-aged children. The effects of the two groups show no intergroup difference, but the 30-min eye-covering pretreatment may be more convenient for practicing. Trial Registration. This study was registered with the No. NCT04973150.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Copyright © 2022 Pei-Fang Dong et al.

Figures

Figure 1
Figure 1
Flowchart of the enrollment data.

References

    1. Bedirli N., Akcabay M., Emik U. Tramadol vs dexmedetomidine for emergence agitation control in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia prospective randomized controlled clinical study. BMC Anesthesiology . 2017;17(1):p. 41. doi: 10.1186/s12871-017-0332-4.
    1. Mason K. P. Paediatric emergence delirium: a comprehensive review and interpretation of the literature. British Journal of Anaesthesia . 2017;118(3):335–343. doi: 10.1093/bja/aew477.
    1. Moore A. D., Anghelescu D. L. Emergence delirium in pediatric anesthesia. Pediatric Drugs . 2017;19(1):11–20. doi: 10.1007/s40272-016-0201-5.
    1. Lin Y., Shen W., Liu Y., et al. Visual preconditioning reduces emergence delirium in children undergoing ophthalmic surgery a randomised controlled trial. British Journal of Anaesthesia . 2018;121(2):476–482. doi: 10.1016/j.bja.2018.03.033.
    1. Yao Y., Sun Y., Lin J., Chen W., Lin Y., Zheng X. Intranasal dexmedetomidine versus oral midazolam premedication to prevent emergence delirium in children undergoing strabismus surgery a randomised controlled trial. European Journal of Anaesthesiology . 2020;37(12) doi: 10.1097/eja.0000000000001270.
    1. Dong P. F., Qiao D. N., Chen H. L., et al. Study on the effect of eye-covering pretreatment on acute delirium after general anesthesia in pre-school aged children. Chinese Journal of Emergency and Critical Care Nursing . 2021;2:107–112.
    1. Kain Z. N., Caldwell-Andrews A. A., Maranets I., et al. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors. Anesthesia and Analgesia . 2004;99(6) doi: 10.1213/01.ane.0000136471.36680.97.
    1. Dai W., Li Y. J., Shi T. Y. Effect of therapeutic play on perioperative period of children. Journal of Nursing . 2016;23:59–60.
    1. Dong P. F., Qiao D. N., Chen H. L., et al. Effects of different lengths of time for covering the eyes before the surgery on emergence delirium in preschool-aged children undergoing general anesthesia for ophthalmic surgery. Journal of Nursing Science . 2022;37
    1. Schulz K. F., Altman D. G., Moher D., Group C. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Obstetrics and Gynecology . 2010;115(5) doi: 10.1097/aog.0b013e3181d9d421.
    1. Mei W., Liu S. K., Zhang Z. G. The validity and reliability of the Chinese version of nursing delirium screening scale. Journal of Nursing Science . 2010;45:101–104.
    1. Mo W. P., Chen L., Guan H., Li N., Zhang X. J. The reliability and validity of the Chinese version of the modified Yale preoperative anxiety scale. Journal of Nursing . 2018;25:17–20.
    1. Garra G., Singer A. J., Taira B. R., et al. Validation of the wong-baker FACES pain rating scale in pediatric emergency department patients. Academic Emergency Medicine . 2010;17(1):50–54. doi: 10.1111/j.1553-2712.2009.00620.x.
    1. Aldecoa C., Bettelli G., Bilotta F., et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. European Journal of Anaesthesiology . 2017;34(4):192–214. doi: 10.1097/eja.0000000000000594.
    1. Tsiotou A. G., Malisiova A., Kouptsova E., Mavri M., Anagnostopoulou M., Kalliardou E. Dexmedetomidine for the reduction of emergence delirium in children undergoing tonsillectomy with propofol anesthesia: a double-blind, randomized study. Pediatric Anesthesia . 2018;28(7):632–638. doi: 10.1111/pan.13397.
    1. Sheng H. W., Zhu Y. L. Effects of monocular and binocular cataract surgery on restlessness in children after sevoflurane anesthesia. The Journal of Practical Medicine . 2019;35
    1. Wang H. Y., Chen T. Y., Li D. J., et al. Association of pharmacological prophylaxis with the risk of pediatric emergence delirium after sevoflurane anesthesia an updated network meta-analysis. Journal of Clinical Anesthesia . 2021;75 doi: 10.1016/j.jclinane.2021.110488.110488
    1. Kim H., Jung S. M., Yu H., Park S. J. Video distraction and parental presence for the management of preoperative anxiety and postoperative behavioral disturbance in children: a randomized controlled trial. Anesthesia & Analgesia . 2015;121(3):778–784. doi: 10.1213/ane.0000000000000839.
    1. Kim Y. S., Cha J. R., Lee Y. S., Kim W. Y., Kim J. H., Kim Y. H. Sugammadex affects emergence agitation in children undergoing strabismus surgery. Journal of International Medical Research . 2018;46(9) doi: 10.1177/0300060518781480.
    1. Weng D. F., Chen S. H., Wu J. Y., et al. Study of peer operating room experience education video on alleviating preoperative anxiety of school-age children. Journal of Nursing and Rehabilitation . 2019;10:86–88.
    1. Zhang M. X., Liang J. W., Zheng Y. Q., Wang Y. L., Yu T. T., Feng S. Y. Efficacy of combination of toy and cartoon video-assisted admission in preventing agitation during recovery from general anesthesia in preschool children. Chinese Journal of Practical Nursing . 2021;37
    1. Bell E. R., Greenfield D. B., Bulotsky-Shearer R. J. Classroom Age composition and rates of change in school readiness for children enrolled in head start. Early Childhood Research Quarterly . 2013;28:1–10. doi: 10.1016/j.ecresq.2012.06.002.
    1. DiCarlo C. F., Baumgartner J. J., Ota C., Geary K. Child sustained attention in preschool-age children. Journal of Research in Childhood Education . 2016;30(2):143–152. doi: 10.1080/02568543.2016.1143416.
    1. Patros C. H. G., Tarle S. J., Alderson R. M., Lea S. E., Arrington E. F. Planning deficits in children with attention-deficit/hyperactivity disorder (ADHD): a meta-analytic review of tower task performance. Neuropsychology . 2019;33(3):425–444. doi: 10.1037/neu0000531.
    1. Blewitt P., Langan R. Learning words during shared book reading: the role of extratextual talk designed to increase child engagement. Journal of Experimental Child Psychology . 2016;150:404–410. doi: 10.1016/j.jecp.2016.06.009.
    1. Key A. P., Dykens E. M. Incidental memory for faces in children with different genetic subtypes of Prader-Willi syndrome. Social Cognitive and Affective Neuroscience . 2017;12(6):918–927. doi: 10.1093/scan/nsx013.
    1. Gerbier E., Toppino T. C. The effect of distributed practice: neuroscience, cognition, and education. Trends in Neuroscience and Education . 2015;4(3):49–59. doi: 10.1016/j.tine.2015.01.001.

Source: PubMed

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