Observational studyPaediatric anaesthesia2026
Association of Preoperative Inflammatory Markers With Preoperative Anxiety and Emergence Agitation in Children.
Observational study in Paediatric anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06648122 (Association of Preoperative Inflammatory Markers With Preoperative Anxiety and Emergence Agitation in Children), which is not on this map. Not yet cited in PubMed.
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Association of Preoperative Inflammatory Markers With Preoperative Anxiety and Emergence Agitation in Children
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7 authors.
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Abstract
introductionEmergence agitation (EA) is a postoperative neurobehavioral complication characterized by a transient disturbance in cognition and perception following anesthesia. Neuroinflammation is thought to play a central role in its pathophysiology. Preoperative anxiety is the "acute preoperative stress response." This study aimed to evaluate the relationship between hemogram-derived inflammatory markers and the development of preoperative anxiety and EA in pediatric patients.
methodsThis prospective observational study included 350 pediatric patients aged 5-12 years with ASA grade I-II. Preoperative anxiety was assessed in the waiting room using the modified Yale Preoperative Anxiety Scale. Demographic and clinical data, anesthesia/surgical data, and hemogram parameters were recorded. EA was evaluated in the recovery room using the Pediatric Anesthesia Emergence Delirium scale. Pain was assessed at 0, 5, 10, 20, and 30 min using the FLACC scale in children < 7 years and the Visual Analog Scale in those ≥ 7 years.
resultsOf the total 350 patients, 130 (37.1%) developed EA. Compared with those without EA, children with EA had significantly higher leukocyte, monocyte, neutrophil, and platelet counts (p = 0.018, 0.005, 0.001, and 0.001, respectively), lower lymphocyte counts (p = 0.042), and elevated monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammatory index (SII) (all p < 0.001). Regression analysis showed that younger age, higher postoperative pain scores, and elevated SII were independently associated with EA. Preoperative anxiety was observed in 103 children (29.4%). These patients had higher white blood cell counts (p = 0.026), and regression analysis identified that younger age, anxious parents, and elevated SII were independently associated with preoperative anxiety.
conclusionEasily obtainable hemogram-derived inflammatory markers, particularly SII, may be useful for identifying children at increased risk of preoperative anxiety and EA in children. These findings suggest that SII may assist anesthesiologists in identifying high-risk patients and implementing preventive strategies to reduce the incidence of EA.
trial registrationThe study was registered at ClinicalTrials.gov (NCT06648122).
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