• Bei Feng, Yuhao Guo, Shaling Tang, Tie Zhang, Yubo Gao, and Xinli Ni.
• Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, 804, Shengli South Street, Xingqing District, Yinchuan, 750004, China.
• J Anesth. 2024 Apr 1; 38 (2): 206214206-214.

PurposeThe study aimed to investigate potential risk factors for emergence delirium (ED) in pediatric patients after tonsillectomy and adenoidectomy (T&A).MethodsThis prospective, single-center observational study enrolled children aged 3-7 years who underwent T&A under general anesthesia. ED was assessed according to DSM-IV or V criteria. Receiver operating characteristic curve analysis was performed to evaluate the predicative and cut-off values of risk factors, including age, preoperative anxiety level, postoperative pain and neutrophil-lymphocyte ratio (NLR) for ED. Univariate and multivariate logistic regression analyses were performed to investigate risk factors for ED.Results94 pediatric patients who underwent T&A were enrolled and 19 developed ED (an incidence of 25.3%). Receiver operating characteristic analysis indicated that preoperative NLR was a significant predictor of ED with a cut-off value of 0.8719 and an area under the curve (AUC) of 0.671 (95% confidence interval (CI) 0.546-0.796, P = 0.022). Preoperative NLR (< 0.8719) and postoperative pain were independent risk factors associated with ED (odds ratio: 0.168, 95% CI 0.033-0.858, P = 0.032; odds ratio: 7.298, 95% CI 1.563-34.083, P = 0.011) according to multivariate logistic regression analysis.ConclusionsPreoperative NLR level and postoperative pain were independent risk factors for ED in pediatric patients undergoing T&A.© 2024. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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