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awareness area:"Anesthesiology"

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1741. Detection of awareness in surgical patients with EEG-based indices--bispectral index and patient state index. (Abstract)

Detection of awareness in surgical patients with EEG-based indices--bispectral index and patient state index. Patient state index (PSI) and bispectral index (BIS) are values derived from the EEG, which can measure the hypnotic component of anaesthesia. We measured the ability of PSI and BIS to distinguish consciousness from unconsciousness during induction and emergence from anaesthesia and a period of awareness in surgical patients.Forty unpremedicated patients were randomized to receive: (1 (...) (23)) were significantly less than at responsiveness (BIS, 79 (14); PSI, 77 (18); P<0.05). The wide variation with both BIS and PSI measurements of the 80 'awareness' values led to an erroneous classification as unconscious in some cases (BIS, six patients; PSI, nine patients). P(k) was 0.68 (0.03) (BIS) and 0.69 (0.03) (PSI).Despite significant differences between mean values at responsiveness and non-responsiveness for BIS and PSI, neither measure may be sufficient to detect awareness

2003 British Journal of Anaesthesia Controlled trial quality: uncertain

1742. Awareness: Monitoring versus remembering what happened. (Abstract)

Awareness: Monitoring versus remembering what happened. Awareness during anesthesia is foremost assessed with postoperative interviews, which may underestimate its incidence. On-line monitors such as the Bispectral Index and patient response to verbal command are not necessarily commonly used. This study investigated response to command during deep sedation (Bispectral Index 60-70) and the ability of prevailing monitoring techniques to indicate awareness and predict recall.The authors (...) was observed to 56 (5%) commands, and an unequivocal response was observed to 139 (13%) commands. Of the 37 patients (66%) with an unequivocal response to command ("awareness"), nine (25%) reported conscious recall after recovery. Their reports provided valuable insights as to how awareness may be adequately addressed. Hemodynamic variables poorly predicted awareness, whereas parameters derived from the encephalogram, especially the Bispectral Index, were highly significant predictors (P < 0.0001

2003 Anesthesiology Controlled trial quality: uncertain

1743. Studies in fentanyl-supplemented anaesthesia: awareness and effect of naloxone on early post-operative recovery. (Abstract)

Studies in fentanyl-supplemented anaesthesia: awareness and effect of naloxone on early post-operative recovery. Ninety-nine unselected patients were given a standardized general anaesthetic with fentanyl 1.5 microgram . kg-1 every 30 minutes and were randomly divided into three equal groups; Group I patients received naloxone 0.1 mg. Group II naloxone 0.2 mg and Group III naloxone 0.4 mg intravenously at the end of the operation and after the reversal of neuromuscular blockade. After naloxone (...) the level of consciousness lightened and the response to stimulus increased: the changes were significant in all three groups and the actual changes were significantly greater in Groups II and III compared with Group I. In the Recovery Room there was no significant difference among the Groups for shivering, nausea, vomiting or pain. The incidence of operative awareness was one per cent and that of dreaming eight per cent and this was unrelated to naloxone dosage. Patient acceptance was high, seven

1981 Canadian Anaesthetists' Society journal Controlled trial quality: uncertain

1744. Comparison of 1.5% enflurane with 1.25% isoflurane in oxygen for caesarean section: avoidance of awareness without nitrous oxide. (Abstract)

Comparison of 1.5% enflurane with 1.25% isoflurane in oxygen for caesarean section: avoidance of awareness without nitrous oxide. We examined the feasibility of administering nearly 100% oxygen throughout the induction-delivery period of general anaesthesia for 113 Caesarean sections. Isoflurane 1.25% was compared with 1.5% enflurane for maintenance of anaesthesia. The level of anaesthesia was monitored by use of the isolated forearm technique. There was a greater amount of isolated forearm (...) movement when enflurane was used. The three main criteria for a satisfactory general anaesthetic technique for Caesarean section were fulfilled, namely no maternal awareness, no undue depression of the fetus and no adverse effect on uterine contractility. Isoflurane and enflurane appear to be suitable anaesthetic agents for facilitating hyperoxygenation during Caesarean section.

1989 British Journal of Anaesthesia Controlled trial quality: uncertain

1745. Awareness following different techniques of general anaesthesia for caesarean section. (Abstract)

Awareness following different techniques of general anaesthesia for caesarean section. Using the isolated arm technique, the frequency of awareness was evaluated in 50 full-term patients undergoing elective Caesarean section under general anaesthesia. In 20 patients, anaesthesia was induced with thiopentone 4 mg kg-1, and in the other 30 patients, induction was with ketamine 1.5 mg kg-1. Following suxamethonium 1.5 mg kg-1 and tracheal intubation, anaesthesia was supplemented during (...) the induction-delivery period in the thiopentone group with 50% nitrous oxide and 0.5% halothane in oxygen in 10 patients, and with 1% halothane in 100% oxygen in the other 10 patients. In the ketamine group, the patients underwent ventilation with 50% nitrous oxide and 0.5% halothane in oxygen in 10 patients, with 1% halothane in 100% in 10 patients, and with 100% oxygen only in the last 10 patients. Awareness was significantly greater after induction with thiopentone (14/20) than after ketamine (4/30

1989 British Journal of Anaesthesia Controlled trial quality: uncertain

1746. Moderation of morbidity following tonsillectomy and adenoidectomy: a study of awareness under anesthesia. (Abstract)

Moderation of morbidity following tonsillectomy and adenoidectomy: a study of awareness under anesthesia. Sixty-seven children between the ages 3 and 10, undergoing tonsillectomy and adenoidectomy, were randomly assigned to one of 3 groups. Therapeutic suggestions recited in English (n = 31), French (n = 19), or continuous white noise (n = 18) were repetitively administered by means of earphones in a double blind design. Randomization to the English condition was associated with a more

1990 International journal of pediatric otorhinolaryngology Controlled trial quality: uncertain

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