Study of paediatric postoperative delirium and acute pain in low surgical risk procedures

  • Victor Hugo González-Cardenas a. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. b. School of Medicine, Universidad de la Sabana, Bogotá, Colombia. c. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. d. "DEORUM OPUS" Group for the study of Anesthesiology, Department of Anesthesiology, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia
  • Fredy Danilo Munar-González a. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. b. Clínica Country, Bogotá, Colombia. c. Clínica de la Mujer, Bogotá, Colombia. d. "DEORUM OPUS" Group for the study of Anesthesiology, Department of Anesthesiology, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia
  • Igor Leonardo Pinzón-Villazon a. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. b. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. c. Hospital de Suba, Bogotá, Colombia. d. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
  • Sergio Hernando Cabarique-Serrano a. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. b. School of Medicine, Universidad de la Sabana, Bogotá, Colombia. c. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. d. Clínica Universitaria de la Sabana, Chía, Colombia. e. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
  • Claudia Cecilia Burbano-Paredes a. Clínica de la Mujer, Bogotá, Colombia. b. Marketing and Quality, SEDAMOS S.A.S, Bogotá, Colombia. c. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
  • Nataly Cháves-Rojas a. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. b. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. c. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
  • John Jairo Rodríguez a. School of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. b. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
  • Victor Daniel Meneses a. Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia. b. Anaesthesia research, mandatory social service, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia. c. "Deorum Opus" group for the study of Anesthesiology; Anesthesiology Department, Fundación Hospital Infantil Universitario de San José, Bogotá, Colombia.
Keywords: Acute Pain, Delirium, Pain, Child, Pain Postoperative

Abstract

Introduction:

Postoperative delirium is not only an outcome of unknown precise incidence in pediatrics but also a controversial field for pediatric anesthesiology.

Objective:

To estimate the incidence of postoperative pediatric delirium in low surgical risk procedures and to analyze risk factors (such as acute postoperative pain).

Materials and methodology:

Prospective analytical observational study of incident cohort that included patients between 2 and 10 years of age, American Society of Anesthesiology I to II, undergoing low-risk surgery. Sample size: probable incidence 33%, accuracy 5%, confidence 95%, n = 340 patients. Sequential sample selection was done after admission to the operating room. Concurrent and longitudinal follow-up was carried out.

Results:

Incidence of delirium was 13.2%. A strong relationship was found between the presence of severe acute postoperative pain and delirium. Dexamethasone was a risk factor. A high association was found between remifentanil and severe acute postoperative pain.

Conclusions:

A low incidence of delirium was found as compared with other reports in the world literature. The diagnostic strength of the scales used is controversial because of the similarities between measurement parameters. Scientific evidence that challenges the use of dexamethasone as a triggering factor is offered. A direct association between pain and delirium is found, and it is even argued that the use of remifentanil could favor the presence of severe acute postoperative pain (hyperalgesia).

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How to Cite
1.
González-Cardenas VH, Munar-González FD, Pinzón-Villazon IL, Cabarique-Serrano SH, Burbano-Paredes CC, Cháves-Rojas N, Rodríguez JJ, Meneses VD. Study of paediatric postoperative delirium and acute pain in low surgical risk procedures. Colomb. J. Anesthesiol. [Internet]. 2018Apr.1 [cited 2021May12];46(2):126-33. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/206

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Published
2018-04-01
How to Cite
1.
González-Cardenas VH, Munar-González FD, Pinzón-Villazon IL, Cabarique-Serrano SH, Burbano-Paredes CC, Cháves-Rojas N, Rodríguez JJ, Meneses VD. Study of paediatric postoperative delirium and acute pain in low surgical risk procedures. Colomb. J. Anesthesiol. [Internet]. 2018Apr.1 [cited 2021May12];46(2):126-33. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/206
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