Reduced regional cerebral oxygen saturation increases risk for emergence delirium in pediatric patients

Objectives To assess whether decreased regional cerebral oxygen saturation (rScO 2 ) is associated with the emergence delirium (ED) following general anesthesia in the pediatric population. Methods A retrospective observational cohort study was conducted on 113 children (ASA I–III) aged 2–14 years who underwent selective surgery under general anesthesia between 2022-01 and 2022-04. Intraoperatively, the rScO 2 was monitored using a cerebral oximeter. The Pediatric Anesthesia Emergence Delirium (PAED) score was used to evaluate the patients for ED. Results The incidence of ED was 31%. Low rScO 2 was reported in 41.6% of patients, who had a higher incidence of ED ( P < 0.001) than those who did not experience desaturation. Logistic regression analysis revealed that decreased rScO 2 was significantly associated with incident ED events [odds ratio (OR), 10.77; 95% confidence interval, 3.31–35.05]. Children under 3 years of age had a higher incidence of ED after rScO 2 desaturation during anesthesia compared to older children (OR, 14.17 vs. 4.64). Conclusion Intraoperative rScO 2 desaturation significantly increased the incidence of ED following general anesthesia. Monitoring should be enhanced to improve the oxygen balance in vital organs to improve the quality and safety of anesthesia.