A Review of Current Literature of Interest to the Office-Based Anesthesiologist

Preoperative fasting in children can increase anxiety; however, no previously published data are available to determine whether duration of preoperative fasting correlates with postoperative emergence delirium. The aim of this study was to identify any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. A total of 100 children between the ages of 2 and 6 years, of American Society of Anesthesiologists physical status I or II, and scheduled for examination of the eye under general anesthesia with sevoflurane were studied. Data regarding preoperative fasting were recorded, and the presence of emergence delirium was assessed by the Pediatric Anesthesia Emergence Delirium (PAED) scale. No premedication was used in any patients, but parental presence was allowed for all of them. Mean (standard deviation) duration of fasting to clear liquid was 6.3 ± 1.7 hours. Twenty-four children (24%) had at least 1 recorded PAED score >10 at any time point in the postoperative period. PAED scores at 15 and 25 minutes were significantly correlated with duration of fasting. No correlation was found between duration of fasting and blood glucose level or between fasting blood glucose and PAED score at any time point. The authors conclude that increased preoperative fasting duration may be a risk factor for postoperative emergence delirium in children undergoing ophthalmic examination under general anesthesi