{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:54:05Z","timestamp":1789430045873,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,1,8]],"date-time":"2015-01-08T00:00:00Z","timestamp":1420675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Children commonly display early postoperative negative behavior (e\u2010\n                      <jats:styled-content style=\"fixed-case\">PONB<\/jats:styled-content>\n                      ) after general anesthesia, which includes emergence delirium (\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      ), discomfort, temperament, and pain. However, it is often difficult for the caregiver to discriminate between various aspects of e\u2010\n                      <jats:styled-content style=\"fixed-case\">PONB<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This prospective observational study evaluates the possibility to distinguish between\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      and pain in young children using validated pediatric observational scales in the early postoperative phase.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following institutional approval and written consent, children undergoing elective adenoidectomy and\/or tonsillectomy were enrolled. Following standardized anesthesia, two trained observers simultaneously evaluated children's behavior with the Paediatric Anaesthesia Emergence Delirium Scale (\n                      <jats:styled-content style=\"fixed-case\">PAED<\/jats:styled-content>\n                      ) and with the Face, Legs, Activity, Cry, Consolability scale (\n                      <jats:styled-content style=\"fixed-case\">FLACC<\/jats:styled-content>\n                      ) at extubation, and at 5, 10, and 15\u00a0min.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 150 children that completed the study, 32 (21%) had\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      , 7 (5%) had pain, and 98 (65%) had simultaneously both\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      and pain. The association of \u2018No eye contact\u2019, \u2018No purposeful action\u2019 and \u2018No awareness of surroundings\u2019 (\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      1) had a sensitivity of 0.96 and a specificity of 0.80 (\n                      <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>\n                      0.97,\n                      <jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>\n                      0.78) to identify\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      . \u2018Inconsolability\u2019 and \u2018Restlessness\u2019 (\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      2) had a sensitivity of 0.69 and a specificity of 0.88 (\n                      <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>\n                      0.83 and\n                      <jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>\n                      0.78) to identify pain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      It is difficult to differentiate between\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      and pain using\n                      <jats:styled-content style=\"fixed-case\">FLACC<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">PAED<\/jats:styled-content>\n                      scores. \u2018No eye contact\u2019, \u2018No purposeful action\u2019, and \u2018No awareness of surroundings\u2019 significantly correlated with\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      . \u2018Inconsolability\u2019 and \u2018Restlessness\u2019 are not reliable enough to identify pain or\n                      <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>\n                      in the first 15\u00a0min after awakening.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pan.12580","type":"journal-article","created":{"date-parts":[[2015,1,8]],"date-time":"2015-01-08T06:53:06Z","timestamp":1420699986000},"page":"524-529","source":"Crossref","is-referenced-by-count":60,"title":["Emergence delirium, pain or both? a challenge for clinicians"],"prefix":"10.1111","volume":"25","author":[{"given":"Marta","family":"Somaini","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Niguarda Ca' Granda Hospital Milan\u2010Bicocca University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Sahillio\u011flu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation Ac\u0131badem University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Marzorati","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care San Gerardo Hospital Milan\u2010Bicocca University Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Lovisari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care San Gerardo Hospital Milan\u2010Bicocca University Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Engelhardt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Royal Aberdeen Children's Hospital Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2290-3142","authenticated-orcid":false,"given":"Pablo M.","family":"Ingelmo","sequence":"additional","affiliation":[{"name":"McGill University Health Centre Montreal Children's Hospital Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000250914.91881.a8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03328.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03646.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200012000-00006"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2005.05.006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200405000-00015"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199901000-00007"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199804000-00019"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200205000-00023"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200105000-00016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199712000-00006"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.00868.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000096004.96603.08"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2000.00560.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200009000-00012"},{"key":"e_1_2_9_17_1","first-page":"293","article-title":"The FLACC: a behavioral scale for scoring postoperative pain in young children","volume":"23","author":"Merkel SI","year":"1997","journal-title":"Pediatr Nurs"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12038"},{"key":"e_1_2_9_19_1","first-page":"199","volume-title":"Statistica Medica","author":"Armitage P","year":"1996"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12580","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T11:17:25Z","timestamp":1696245445000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12580"}},"subtitle":[],"editor":[{"given":"Jerrold","family":"Lerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,1,8]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1111\/pan.12580"],"URL":"https:\/\/doi.org\/10.1111\/pan.12580","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,8]]}}}