Adenotonsillektomi ve Tonsillektomi operasyonlarında preemptif analjezinin derlenme deliryumu üzerine etkisi

ABSTRACT Objective: Emergency delirium is a phenomenon of unknown etiology, mostly seen in young children, characterised by aggressive behaviour, lack of eye contact and lack of awareness of the environment. It has been shown to have many causes, but head and neck surgery, inhaled agents and post-operative pain are the most common. The PAED scale is the most sensitive scale and a score of 10 or more indicates immediate delirium. Pre-emptive analgesia is the interruption of pain pathways before the painful stimulus occurs, and its effectiveness in post-operative analgesia has been confirmed by many studies. This study was designed with the hypothesis that post-operative pain reduced by pre-emptive analgesia would reduce emergency delirium. Materials and methods: After ethics committee approval, 96 ASAI-II patients aged 2-7 years undergoing adenotonsillectomy and tonsillectomy were randomised into two groups. Analgesics were administered to the pre-emptive group before induction and to the intra-operative group 15 min after the start of surgery. In the recovery room, ED was assessed using the PAED scale and pain scores were assessed using the FLACC scores. PAED>10 was considered recovery delirium. The primary outcome was the incidence of recovery delirium. Secondary outcomes were delirium and pain scores. Results: PAED and FLACC scores were significantly lower in the preemptive group. There was a significant difference in the incidence of ED between the two groups only at 5 minutes. Conclusions: In children undergoing adenotonsillectomy and tonsillectomy, preemptive analgesia reduced postoperative pain scores and delirium scores, but did not reduce the incidence of recovery delirium.