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Detecting wakefulness in anaesthetised children

  • G. F. Byers
  • J. G. Muir
Reports of Investigation

Abstract

Purpose

To investigate the suitability of the isolated forearm technique in detecting wakefulness in children aged 5 to 16 yr.

Methods

Forty-one healthy English speaking children were enrolled. Following intravenous induction of anaesthesia with 5–7 mg·kg−1 thiopentonen. but before administration of 1–1.5 mg·kg−1 succinylcholine a pneumatic toumiquet 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.

Keywords

Nitrous Oxide Halothane Tracheal Intubation Succinylcholine Thiopentone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Déterminer si la technique de I’avant-bras isolé est capable de déceler I’état de veille chez des enfants ågés de 5 à 16 ans.

Méthodes

Quarante et un enfants anglophones participaient à cette étude. Après I’induction de I’anesthésie avec 5–7 mg·kg−1 de thiopentonen, mais avant l’administration de 1–1,5 mg·kg−1 de succinylcholine, un garrot pneumatique était insufflé à 50 mmHg au-dessus de la pression artérielle systolique pour isoler le membre supérieur libre de toute canulation. Par la suite, I’anesthésie était maintenue avec de I’halothane 1,5–2,5% dans le protoxyde d’azote avec oxygène. Après l’administration du relaxant musculaire, on demandait au patient de bouger son bras non paralysé. Le mouvement était vérifié à des intervalles de 30 sec et s’il apparaissait sur commande, il était considéré comme une manifestation de I’état de veille.

Résultats

Un mouvement de I’avant-bras isołé a été observé chez 19,5% des enfants. Le plus jeune à répondre avait cinq ans.

Conclusion

La technique de I’avant-bras isołé peut détecter I’état de veille pendant et immédiatement après l’intubation de la trachée chez des enfants à partir de I’åge de cinq ans.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  1. 1.Department of Paediatric AnaesthesiaIzaak Walton Killam-Grace Health Centre For Children, Women & FamiliesHalifax

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