In the present study, we investigated the hypothesis that the depth of
general anesthesia affects
emergence agitation (EA) in children in the early postanesthetic period. We retrospectively examined male and female children (aged 1-9 years) who underwent
ambulatory surgery that lasted < 2 h. Various parameters, including the modified Yale Preoperative Anxiety Score (mYPAS) before
anesthesia induction, the
Pediatric Anesthesia Emergence Delirium (PAED) score at recovery time, and the value of the patient state index (PSI), were extracted from our electronic
anesthesia database. The relationships between the PAED score and the mean PSI values were examined with univariate analyses. We also investigated the associations among the mean PSI,
propofol anesthesia, age, mYPAS, the type of surgery, and the total amount of
fentanyl divided by
body weight with the PAED score using multiple regression analysis with interaction terms. There were 32 and 34 patients in the
sevoflurane and
propofol groups, respectively. The PAED scores (all patients: r = -0.34, p = 0.0048;
sevoflurane group: r = -0.37, p = 0.036) were negatively correlated with the mean PSI, whereas the PAED score in the
propofol group [r = 0.31 (-0.03, 0.59), p = 0.073] did not show a significant positive correlation with the mean PSI in the univariate analysis. The multiple linear regression analysis outcomes revealed that the mean PSI value was an independent clinical factor associated with the PAED score. Intraoperative electroencephalogram monitoring may be proved as one of the useful tools for the assessment of EA risks in children.