A Clinical Trial On Alleviating Paediatric Emergence Delirium After General Anesthesia By Preoperative Light Drinking

Objective: To investigate the feasibility and effectiveness of reducing paediatric emergence delirium after general anesthesia by preoperative light drinking.Method: A total of 334 preschool children aging from 2-7 years old were selected with both boys and girls.The children were randomly divided into 4 groups according to the random number table: routine fasting(RF)group(n=83),Midazolam(MZ)group(n=80),clear water(CW)group(n=85)and light drinking(LD)group(n=86).All patients from the 4 groups arefasted since 23 pm before the operation day.Patients from RF group received no other treatments;patients from MZ group were given midazolam injection(0.1mg/kg)byintranasal administration at 8 am on the operation day;patients from CW group were given clear water(5ml/kg)at 7 am on the operation day and patients from LD group were given 5% glucose solution(5ml/kg)at 7 am on the operation day;all patients received general anesthesia and the vital signs were continuously monitored during the operation.The Anxiety score were estimated according to mYPAS(modified Yale Preoperative Anxiety Scale)at the 5 following time points: preoperative visit,entering anesthesia preparation area,entering the operating room,anesthesia induction and postoperative visit.After the patients were recovered from the general anesthesia,they were estimated using FLACC scale(Face-Legs-Activity-Cry-Consolability)and PAED scale(Pediatric Anesthesia Emergence Delirium)and all the scores at the monmentof extubation,5mins after extubation,10 mins after extubation,15 mins after extubation,20 mins after extubation,25 mins after extubation,30 mins after extubation,and leaving the PACU.The biochemical indicators of blood glucose,blood lactic acid and electrolyte of all patients at preoperative visit,entering anesthesia preparation area,PACU and at postoperative visit were recorded.Results: Anxiety scores of the RF group before anesthesia on the day of surgery were higher than those of the other three groups,and the difference was statistically significant(P<0.05).There was no significant difference in anxiety scores between MZ group,CW group and LD group(P>0.05).There was no statistically significant difference between LD group,MZ group and CW group(P>0.05)in the score of PAED,while the RF group was higher than the other three groups,and the difference was statistically significant(P<0.05).The blood glucose value of LD group was higher than that of the other three groups at the same time,and the difference was statistically significant(P<0.05).The plasma osmotic pressure of LD group and CW group was lower than that of RF group and MZ group,and the difference was statistically significant(P<0.05).There were no significant differences in blood lactic acid,electrolyte,vital signs,preoperative visit and postoperative visit between the four groups(P>0.05).Conclusion: It is safe and feasible to apply light drinking for preschool children before selective operations,which can reduce the hunger and thirst,reliving preoperative anxiety and effectively alleviatepaediatricemergence delirium.