Why some children wake up delirious from anaesthesia

August 11, 2014, Murdoch Childrens Research Institute

(Medical Xpress)—In a world-first, a newly published study has captured in detail the brain electrical activity in children as they emerge from anaesthesia, shedding light on why some are distressed and agitated when they wake up.

Researchers from Swinburne University of Technology together with colleagues from the Murdoch Childrens Research Institute were able to collect electroencephalography (EEG) data on who exhibited emergence delirium.

Emergence delirium is a major risk associated with in children and occurs when patients wake up from anaesthesia in a delirious and disassociated state.

Swinburne Professor David Liley said PhD student Jessica Martin and staff at Murdoch Childrens were able to record, with unprecedented fidelity, brain electrical activity from 60 children aged 5-15 years who emerged from anaesthesia some of whom went on to exhibit emergence delirium.

"This clinical phenomenon is prevalent in children aged six and under, with an estimated 10-30% exhibiting emergence delirium," said Professor Liley.

Researchers found that the brain activity recorded just after stopping sevoflurane (a form of gas anaesthesia) in children exhibiting emergence delirium was substantially different to those children who woke up peacefully.

Associate Professor Davidson from Murdoch Childrens said they discovered that children who wake up suddenly from a deeper plane of anaesthetic are more likely to develop the delirium.

"In contrast, the children who develop sleep like patterns on their EEG before they wake up are more likely to wake up peacefully."

"Intriguingly, emergence delirium looks very much like the more severe form of night terror, which occurs when some pre-school children are disturbed during deep sleep.

"Our study suggests the EEG signatures and the mechanisms may indeed be similar between night terror and emergence delirium.

"Allowing children to wake up in a quiet and undisturbed environment should increase the likelihood that they go into a light sleep-like state after the anaesthetic and then wake up peacefully," said Associate Professor Davidson.

The findings will have significant implications in both predicting those children who will go on to develop emergence delirium, as well as helping medical professionals better understand its causes in both children and adults.

The study, Alterations in the Functional Connectivity of Frontal Lobe Networks Preceding Emergence Delirium in Children, will appear in the October issue of the high profile clinical journal, Anesthesiology and is electronically available ahead of print.

Explore further: Metabolic patterns of propofol, sevoflurane differ in children

Related Stories

Metabolic patterns of propofol, sevoflurane differ in children

October 26, 2012
(HealthDay)—For children undergoing routine anesthesia for medically indicated magnetic resonance imaging (MRI), the metabolic signature varies with use of sevoflurane and propofol, according to a study published in the ...

Sleep apnea puts patients at risk for delirium after surgery

March 27, 2012
An anecdotal observation of a possible link between sleep apnea and post-surgical delirium has been measured and confirmed by a team of researchers at the Duke University Medical Center.

Steroids prescribed in the ICU linked to delirium

May 27, 2014
New Johns Hopkins research suggests that critically ill patients receiving steroids in a hospital's intensive care unit (ICU) are significantly more likely to develop delirium. Results of their research, they say, suggest ...

Boston-area researchers develop new delirium severity measure for older adults

April 14, 2014
A new method for measuring delirium severity in older adults has been developed by researchers from Harvard, Brown, and UMASS. The new scoring system, CAM-S, is based on the Confusion Assessment Method (CAM) and standardizes ...

Recommended for you

How your brain remembers what you had for dinner last night

January 17, 2018
Confirming earlier computational models, researchers at University of California San Diego and UC San Diego School of Medicine, with colleagues in Arizona and Louisiana, report that episodic memories are encoded in the hippocampus ...

Recording a thought's fleeting trip through the brain

January 17, 2018
University of California, Berkeley neuroscientists have tracked the progress of a thought through the brain, showing clearly how the prefrontal cortex at the front of the brain coordinates activity to help us act in response ...

Midbrain 'start neurons' control whether we walk or run

January 17, 2018
Locomotion comprises the most fundamental movements we perform. It is a complex sequence from initiating the first step, to stopping when we reach our goal. At the same time, locomotion is executed at different speeds to ...

A 'touching sight': How babies' brains process touch builds foundations for learning

January 16, 2018
Touch is the first of the five senses to develop, yet scientists know far less about the baby's brain response to touch than to, say, the sight of mom's face, or the sound of her voice.

Brain zaps may help curb tics of Tourette syndrome

January 16, 2018
Electric zaps can help rewire the brains of Tourette syndrome patients, effectively reducing their uncontrollable vocal and motor tics, a new study shows.

Researchers identify protein involved in cocaine addiction

January 16, 2018
Mount Sinai researchers have identified a protein produced by the immune system—granulocyte-colony stimulating factor (G-CSF)—that could be responsible for the development of cocaine addiction.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.