Emergence Delirium and Its Association with Preoperative Anxiety in Paediatric Patients Undergoing Infra Umbilical Surgery Under Combined General and Caudal Anaesthesia: An Observational Study from a Tertiary Care Centre in a South Asian Country.

OBJECTIVE: The objective of this observational study was to determine the incidence of emergence delirium (ED) and its association with preoperative anxiety using the modified Yale preoperative anxiety scale and paediatric anaesthesia emergence delirium scale, in a tertiary care institution in South Asia.
METHODS: A total of 250 children of 2-8 years of age (of either gender, American Society of Anaesthesiology classification I or II, undergoing infra umbilical surgery, using caudal block for analgesia) were enrolled and the study was completed. The primary outcome measure was the presence of ED using the paediatric anaesthesia emergence delirium score. A cut-off value equal to or more than 12 at any time point was taken as ED. The secondary measure was preoperative anxiety, measured using the modified Yale preoperative anxiety scale at 30 minutes before going into the operating room. A cut-off score of 30 was used.
RESULTS: The median age of the children was thirty-six months IQR (24-60). There were 230 (91%) males and 20 (9%) females. Twenty-two percent of the children experienced emergence delirium. One-point increase of modified Yale preoperative anxiety scale anxiety score was significantly associated with 1.23 times the odds of emergence delirium OR =1.23 (1.16-1.29) as compared with those without emergence delirium.
CONCLUSIONS: The incidence of emergence delirium in our cohort was 22.4%, and there was a significant association between preoperative anxiety and emergence delirium.