{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T04:24:52Z","timestamp":1787372692074,"version":"build-2736575974"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"\n Importance<\/jats:title>\n The potential benefits of using electroencephalography (EEG)\u2013guided anesthesia for the prevention of emergence delirium in children remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether the intraoperative use of EEG-guided anesthesia is associated with a lower incidence of emergence delirium in pediatric patients.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n PubMed, Embase, and Cochrane databases were searched until July 2025. Searches followed PRISMA guidelines and were registered in PROSPERO.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n From 185 studies screened by 2 authors, 9 randomized clinical trials met the inclusion criteria: patients aged 1 to 18 years undergoing general anesthesia, comparing EEG-guided anesthesia with standard practice. Included studies reported at least 1 of the following outcomes: emergence delirium, pediatric anesthesia emergence delirium score, postanesthesia care unit length of stay, end-tidal sevoflurane concentration, or burst suppression.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Data containing risk ratios (RRs) and mean differences (MDs) with 95% CIs were extracted from randomized clinical trials. Quality assessment and certainty of evidence were performed using the Risk of Bias 2 (RoB-2) tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was the incidence of emergence delirium, a common postanesthesia psychomotor pediatric complication measured by pediatric anesthesia emergence delirium score greater than or equal to 10. This outcome was prespecified before data extraction and analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1052 patients from 9 included studies were included in this analysis, of whom 535 (50.9%) underwent EEG-guided anesthesia. The incidence of emergence delirium was significantly lower in the EEG-guided group compared with the standard-practice group (27% vs 48%; RR, 0.56; 95% CI, 0.37-0.84;\n P<\/jats:italic>\n \u2009=\u2009.005). Maximum pediatric anesthesia emergence delirium scores (MD, \u22120.87; 95% CI, \u22121.52 to \u22120.23;\n P<\/jats:italic>\n \u2009=\u2009.008), end-tidal sevoflurane concentration (MD, \u22120.40; 95% CI, \u22120.58 to \u22120.22;\n P<\/jats:italic>\n \u2009&amp;lt;.001), and length of stay in the postanesthesia care unit (MD, \u22128.20; 95% CI, \u221213.35 to \u22123.04;\n P<\/jats:italic>\n \u2009=\u2009.002) were also significantly lower in the EEG-guided anesthesia group. There was no statistically significant difference in the number of burst suppression episodes between the 2 groups (12% vs 17%; RR, 0.69; 95% CI, 0.42-1.12;\n P<\/jats:italic>\n \u2009=\u2009.14).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This systematic review and meta-analysis reveals that use of EEG-guided anesthesia was associated with a significantly lower risk of emergence delirium compared with standard practice in children.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapediatrics.2025.6005","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T16:00:20Z","timestamp":1770048020000},"page":"394","source":"Crossref","is-referenced-by-count":2,"title":["EEG-Guided Anesthesia for the Prevention of Emergence Delirium in Children"],"prefix":"10.1001","volume":"180","author":[{"given":"Luwa","family":"Haidar","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Abadi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalia","family":"Sarieddine","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Vitali","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, School of Medicine, Sapienza University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouad A.","family":"Zouein","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, 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