Awareness, muscle relaxants and balanced anaesthesia

Mainzer, Jacob

doi:10.1007/bf03006453

Cited by 34 publications

(5 citation statements)

References 84 publications

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“…Most reported cases of unintentional awareness during surgery consists of patients who are awake but unable to move because of muscle paralysis. 16,20,22 Traumatic episodes of awareness are invariably associated with muscle paralysis. 20 Awareness can occur in the absence of muscle relaxants but the problem is usually detected quickly because the patient moves.…”

Section: Critical Role Of Muscle Relaxantsmentioning

confidence: 99%

BIS EEG monitoring: what it can and cannot do in regard to unintentional awareness

Plourde

2002

Can J Anesth/J Can Anesth

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Section: Critical Role Of Muscle Relaxantsmentioning

confidence: 99%

BIS EEG monitoring: what it can and cannot do in regard to unintentional awareness

Plourde

2002

Can J Anesth/J Can Anesth

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“… 2 While there are numerous articles dealing with recall in the anesthesia literature, there is a paucity of research regarding the effectiveness of RSI in preventing patient recollection during intubation in the emergency department. 3 – 8 Bispectral index, a computer-derived index determined from electroencephalography, has been used to monitor the level of awareness of sedated patients during procedures in the emergency department but has not been an unequivocally reliable measure of clinical sedation. 9 , 10 Research on recollection from the patient's perspective during long-term intubation in the intensive care unit suggests that recall of stressful experiences is a significant issue.…”

Section: Introductionmentioning

confidence: 99%

Rapid Sequence Intubation from the patien

Kimball¹,

Kincaide²,

Ives³

et al. 2011

WestJEM

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IntroductionThis study assesses the efficacy of the rapid sequence intubation (RSI) protocol in preventing patient recollection of resuscitative events and patient discomfort during intubation, as subjectively determined by the patient.MethodsThis was a prospective study of all patients intubated at Los Angeles County, University of Southern California Medical Center from July 2009 to January 2010. Extubated patients were interviewed using a standard questionnaire and data collection tool.ResultsOf 211 airway codes, 201 were excluded due to death before extubation, transfer, or persistent vegetative state, leaving 10 awake, alert subjects who were interviewed regarding their recollection of the RSI and resuscitation. Five had recollection of the event. Most patients recalling RSI described the event as painful or uncomfortable despite receiving the recommended doses of sedation/induction agents.ConclusionIn this cohort of 10 patients intubated using typical agents, 5 remembered some details of their intubation and 2 described pain that was 10/10 on a verbal pain scale. Further work is indicated to ensure that the medications used during this procedure provide the appropriate sedation and amnesia.

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“…2 While there are numerous articles dealing with recall in the anesthesia literature, there is a paucity of research regarding the effectiveness of RSI in preventing patient recollection during intubation in the emergency department. [3][4][5][6][7][8] Bispectral index, a computer-derived index determined from electroencephalography, has been used to monitor the level of awareness of sedated patients during procedures in the emergency department but has not been an unequivocally reliable measure of clinical sedation. 9,10 Research on recollection from the patient's perspective during long-term intubation in the intensive care unit suggests that recall of stressful experiences is a significant issue.…”

Section: Introductionmentioning

confidence: 99%

133: Rapid Sequence Intubation From the Patients' Perspective

Kimball¹,

Ives²,

Henderson³

2008

Annals of Emergency Medicine

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This study assesses the efficacy of the rapid sequence intubation (RSI) protocol in preventing patient recollection of resuscitative events and patient discomfort during intubation, as subjectively determined by the patient. Methods: This was a prospective study of all patients intubated at Los Angeles County, University of Southern California Medical Center from July 2009 to January 2010. Extubated patients were interviewed using a standard questionnaire and data collection tool. Results: Of 211 airway codes, 201 were excluded due to death before extubation, transfer, or persistent vegetative state, leaving 10 awake, alert subjects who were interviewed regarding their recollection of the RSI and resuscitation. Five had recollection of the event. Most patients recalling RSI described the event as painful or uncomfortable despite receiving the recommended doses of sedation/ induction agents. Conclusion: In this cohort of 10 patients intubated using typical agents, 5 remembered some details of their intubation and 2 described pain that was 10/10 on a verbal pain scale. Further work is indicated to ensure that the medications used during this procedure provide the appropriate sedation and amnesia.

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Awareness, muscle relaxants and balanced anaesthesia

Cited by 34 publications

References 84 publications

BIS EEG monitoring: what it can and cannot do in regard to unintentional awareness

BIS EEG monitoring: what it can and cannot do in regard to unintentional awareness

Rapid Sequence Intubation from the patien

133: Rapid Sequence Intubation From the Patients' Perspective

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