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Detecting wakefulness in anaesthetised children
1Department of Paeditric Anaesthesia, Izaak Walton Killam-Grace Health Centre for Children, Women & Families, Halifax, Nova Scotia.
Insights
The isolated forearm technique effectively detects wakefulness in children during anesthesia. This method is suitable for pediatric patients aged five and older, aiding in monitoring consciousness.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Neuroscience
Background:
- Monitoring patient wakefulness during anesthesia is crucial for safety.
- The isolated forearm technique offers a potential method for assessing consciousness in pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of the isolated forearm technique in identifying wakefulness in children aged 8 to 16 years.
- To determine the minimum age for reliable detection of wakefulness using this method.
Main Methods:
- Forty-one healthy children (8-16 years) received anesthesia induction with thiopentone.
- A pneumatic tourniquet isolated one forearm before succinylcholine administration.
- Wakefulness was assessed by instructing patients to move the unparalyzed arm.
Main Results:
- Nineteen point five percent of children demonstrated forearm movement in response to commands.
- The youngest child to respond was five years old, indicating a lower age threshold.
Conclusions:
- The isolated forearm technique is a viable method for detecting wakefulness in children during and after tracheal intubation.
- This technique can be reliably employed in pediatric patients as young as five years old.
Purpose:
To investigate the suitability of the isolated forearm technique in detecting wakefulness in children aged 8 to 16 yr.
Methods:
Forty-one healthy English speaking children were enrolled. Following intravenous induction of anaesthesia with 5-7 mg.kg-1 thiopentone iv, but before administration of 1-1.5 mg.kg-1 succinylcholine a pneumatic tourniquet was inflated to 50 mmHg above systolic pressure in order to isolate the non-cannulated forearm. Thereafter, anaesthesia was maintained with halothane 1.5-2.5% in nitrous oxide and oxygen. Following the muscle relaxant the patient was instructed to move the unparalyzed arm. Movement was checked at 30 sec intervals and if present on command, identified as wakefulness.
Results:
Movement of the isolated forearm to command was observed in 19.5% of children. The youngest child to respond was five years old.
Conclusion:
The isolated forearm technique can be used to detect wakefulness during and immediately following tracheal intubation in children from the age of five years.