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.
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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Byers, G.F., Muir, J.G. Detecting wakefulness in anaesthetised children. Can J Anaesth 44, 486–488 (1997). https://doi.org/10.1007/BF03011935
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DOI: https://doi.org/10.1007/BF03011935