• Li-Nan Zhang, Yi Liu, Qian-Qian Guo, Yu-Ting Ling, Fang Li, Yan-Ling Zheng, Mu-Yao Chen, Feng-Hong Chen, and Nan Jiang.
• Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, No. 58, Zhongshan 2(nd) Road, Guangzhou 510080, China; Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Guangzhou 510635, China. Electronic address: zhangln39@mail2.sysu.edu.cn.
• J Clin Anesth. 2022 Aug 1; 79: 110788.

Study ObjectiveEmergence delirium is a common complication in preschool children after general anesthesia and may result in undesirable complications. This study aimed to determine whether breathing training after watching an informative video during the pre-operative visit could reduce the incidence of emergence delirium in preschool children after otorhinolaryngologic surgery under general anesthesia.DesignA single-center, double-blinded, randomized controlled trial.SettingPerioperative care.PatientsA total of 170 children undergoing otorhinolaryngologic surgery, aged 3-7 years, ASA physical status I or II were involved.InterventionsPatients were randomized to receive breathing training during the pre-operative visit (Training group) or to receive pre-operative visit only (Control group) the day before surgery.MeasurementsEmergence delirium was measured by the Pediatric Anesthesia Emergence Delirium score during the anesthesia recovery time. Data regarding extubation time and post-anesthesia care unit stay time were collected.Main ResultsChildren who received breathing training during the pre-operative visit had a significantly lower incidence of emergence delirium than those who only underwent the pre-operative visit (10.4% vs. 35.1%, P < 0.001). The awakening time score and the maximum score in the post-anesthesia care unit were significantly lower in the training group compared with the control group [4.4 ± 3.4 vs. 6.9 ± 4.2, P < 0.001 and 5.0 (5.0) vs 7.0 (7.0), P = 0.001, respectively]. We found no differences in the extubation time and post-anesthesia care unit stay time between groups.ConclusionsWe concluded that breathing training based on video learning during the pre-operative visit in preschool children undergoing otorhinolaryngologic surgery could significantly decrease the incidence of emergence delirium.Trial RegistrationChinese Clinical Trial Registry (Reference number: ChiCTR1900026162); registered on September 24, 2019.Copyright © 2022 Elsevier Inc. All rights reserved.

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