Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China

Introduction Emergence delirium (ED) stands out as a prevalent postoperative complication among paediatric patients, correlating with extended hospitalisation periods, escalated healthcare expenses and increased incidence of postoperative maladaptive behaviours (POMBs). Well-established pharmacologi...

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Main Authors: Ting Li, Jintao Hu, Fan Ye, Jiaying Chen, Chanfan Zheng, Shengnan Song, Chenxi Yang
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e089863.full
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author Ting Li
Jintao Hu
Fan Ye
Jiaying Chen
Chanfan Zheng
Shengnan Song
Chenxi Yang
author_facet Ting Li
Jintao Hu
Fan Ye
Jiaying Chen
Chanfan Zheng
Shengnan Song
Chenxi Yang
author_sort Ting Li
collection DOAJ
description Introduction Emergence delirium (ED) stands out as a prevalent postoperative complication among paediatric patients, correlating with extended hospitalisation periods, escalated healthcare expenses and increased incidence of postoperative maladaptive behaviours (POMBs). Well-established pharmacological or non-pharmacological interventions demonstrating efficacy in reducing the occurrence of ED are notably absent. Therefore, this study aimed to assess the potential of family-centred perioperative care for anaesthesia (FPCA) in mitigating the incidence of ED in children compared with routine anaesthesia.Method and analysis This multicentre, prospective, open-label, randomised controlled clinical trial will enrol a total of 444 children aged 2–6 years undergoing elective short surgery (estimated duration ≤2 h). According to the stratification factors of surgical types (ophthalmology, ear, nose and throat (Oph&ENT) and non-Oph&ENT surgeries), patients will be randomly allocated into two groups in a 1:1 ratio. For the FPCA group (group F), both children and parents will receive FPCA (including video education, mask practice, electronic pamphlet, distraction strategies and parental presence), without sedatives before surgery. For the routine anaesthesia group (group R), both children and parents will receive routine preoperative education and anaesthesia, and preoperative sedatives (such as oral midazolam or intranasal dexmedetomidine) will be recommended. The primary outcome is the incidence of ED. Secondary outcomes include the severity of ED, incidence of POMBs, cognitive function, quality of sleep and life, preoperative anxiety, compliance with anaesthesia induction and postoperative pain score. Logistic regression will be applied to compare differences in primary and secondary outcomes between groups, and patients’ age, sex, and body mass index will be considered as covariates in baseline measurements.Ethics and dissemination This study protocol was approved by the Ethics Committee of The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University. Results will be disseminated via peer-reviewed journals, academic conferences and mass media. Recruitment began in October 2023.Trial registration number NCT06092671.
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spelling doaj-art-e73a346ebaa24b05a70d46649c2f7cd52025-08-20T03:33:11ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-089863Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in ChinaTing Li0Jintao Hu1Fan Ye2Jiaying Chen3Chanfan Zheng4Shengnan Song5Chenxi Yang6Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaClinical Research Unit, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, ChinaIntroduction Emergence delirium (ED) stands out as a prevalent postoperative complication among paediatric patients, correlating with extended hospitalisation periods, escalated healthcare expenses and increased incidence of postoperative maladaptive behaviours (POMBs). Well-established pharmacological or non-pharmacological interventions demonstrating efficacy in reducing the occurrence of ED are notably absent. Therefore, this study aimed to assess the potential of family-centred perioperative care for anaesthesia (FPCA) in mitigating the incidence of ED in children compared with routine anaesthesia.Method and analysis This multicentre, prospective, open-label, randomised controlled clinical trial will enrol a total of 444 children aged 2–6 years undergoing elective short surgery (estimated duration ≤2 h). According to the stratification factors of surgical types (ophthalmology, ear, nose and throat (Oph&ENT) and non-Oph&ENT surgeries), patients will be randomly allocated into two groups in a 1:1 ratio. For the FPCA group (group F), both children and parents will receive FPCA (including video education, mask practice, electronic pamphlet, distraction strategies and parental presence), without sedatives before surgery. For the routine anaesthesia group (group R), both children and parents will receive routine preoperative education and anaesthesia, and preoperative sedatives (such as oral midazolam or intranasal dexmedetomidine) will be recommended. The primary outcome is the incidence of ED. Secondary outcomes include the severity of ED, incidence of POMBs, cognitive function, quality of sleep and life, preoperative anxiety, compliance with anaesthesia induction and postoperative pain score. Logistic regression will be applied to compare differences in primary and secondary outcomes between groups, and patients’ age, sex, and body mass index will be considered as covariates in baseline measurements.Ethics and dissemination This study protocol was approved by the Ethics Committee of The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University. Results will be disseminated via peer-reviewed journals, academic conferences and mass media. Recruitment began in October 2023.Trial registration number NCT06092671.https://bmjopen.bmj.com/content/15/7/e089863.full
spellingShingle Ting Li
Jintao Hu
Fan Ye
Jiaying Chen
Chanfan Zheng
Shengnan Song
Chenxi Yang
Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
BMJ Open
title Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
title_full Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
title_fullStr Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
title_full_unstemmed Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
title_short Effect of family-centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery: a protocol for a randomised controlled trial in China
title_sort effect of family centred perioperative care for anaesthesia on the incidence of emergence delirium in children after surgery a protocol for a randomised controlled trial in china
url https://bmjopen.bmj.com/content/15/7/e089863.full
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