JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (24) Citing Articles via Google Scholar Google Scholar Articles by Davidson, A. J. Articles by Stargatt, R. Search for Related Content PubMed PubMed Citation Articles by Davidson, A. J. Articles by Stargatt, R. Related Collections Complications Pediatrics

---

PEDIATRIC ANESTHESIA

Awareness During Anesthesia in Children: A Prospective Cohort Study

Andrew J. Davidson, MBBS, GradDipEpiBiostats, FANZCA^*, Grace H. Huang, BMedSci^*, Caroline Czarnecki, BMedSci^*, Margaret A. Gibson, BN, RN^*, Stephanie A. Stewart, BN, RN^*, Kris Jamsen, BSc, PGDip(Stats), and Robyn Stargatt, PhD, MAPS

*Department of Anaesthesia and Pain Management, The Royal Children’s Hospital, Parkville, Victoria, Australia; Department of Pharmacology, University of Melbourne, Melbourne, Victoria, Australia; Clinical Epidemiology and Biostatistics Unit, The Royal Children’s Hospital, Parkville, Victoria, Australia; and Department of Psychology, The Royal Children’s Hospital, Parkville, Victoria, Australia

Address correspondence and reprint requests to Andrew J. Davidson, MBBS, GradDipEpiBiostats, FANZCA, Department of Anaesthesia, Royal Children’s Hospital, Flemington Rd., Parkville 3052, Victoria, Australia. Address e-mail to andrew.davidson{at}rch.org.au.

During routine adult anesthesia, the risk of awareness is 0.1%–0.2%. No recent studies have reported the incidence in children. Altered pharmacology and differing anesthesia techniques suggest that the incidence may differ in children. In this prospective cohort study, we determined the incidence of awareness during anesthesia in children. Eight-hundred-sixty-four children aged 5–12 yr who had undergone general anesthesia at The Royal Children’s Hospital were interviewed on 3 occasions to determine the incidence of awareness. The awareness assessment was nested within a larger study of behavior change after anesthesia. Reports of suspected awareness were sent to four independent adjudicators. If they all agreed, a case was classified as true awareness. Twenty-eight reports were generated. There were 7 cases of true awareness, for an incidence of 0.8% (95% confidence interval, 0.3%–1.7%). Only one aware child received neuromuscular blockers, compared with 12% in the nonaware group. No aware child reported distress, and no substantial difference was detected in behavior disturbance between aware (20%) and nonaware (16%) children. The data provide some evidence that, like adults, children are also at risk of intraoperative awareness. Although the cause remains unclear, anesthesiologists should be alerted to the possibility of awareness in children.

This article has been cited by other articles:

				R. D. Sanders, D. Ma, P. Brooks, and M. Maze Balancing paediatric anaesthesia: preclinical insights into analgesia, hypnosis, neuroprotection, and neurotoxicity Br. J. Anaesth., September 16, 2008; (2008) aen263v1. [Abstract] [Full Text] [PDF]

				C. L. Errando, J. C. Sigl, M. Robles, E. Calabuig, J. Garcia, F. Arocas, R. Higueras, E. del Rosario, D. Lopez, C. M. Peiro, et al. Awareness with recall during general anaesthesia: a prospective observational evaluation of 4001 patients Br. J. Anaesth., August 1, 2008; 101(2): 178 - 185. [Abstract] [Full Text] [PDF]

				J. Andrade, C. Deeprose, and I. Barker Awareness and memory function during paediatric anaesthesia Br. J. Anaesth., March 1, 2008; 100(3): 389 - 396. [Abstract] [Full Text] [PDF]

				M. Daunderer, M. S. Feuerecker, B. Scheller, N. B. Pape, D. Schwender, and G. E. Kuhnle Midlatency auditory evoked potentials in children: effect of age and general anaesthesia Br. J. Anaesth., December 1, 2007; 99(6): 837 - 844. [Abstract] [Full Text] [PDF]

				T. Engelhardt, M. K. Chan, A. J. McCheyne, C. Karsli, I. Luginbuehl, and B. Bissonnette The Effect of Varying Continuous Propofol Infusions on Plasma Cyclic Guanosine 3',5'-Monophosphate Concentrations in Anesthetized Children Anesth. Analg., September 1, 2007; 105(3): 616 - 619. [Abstract] [Full Text] [PDF]

				D. M. Polaner and M. Twite Like Goldilocks, pediatric anesthesiologists look for `just right' AAP News, August 1, 2007; 28(8): 19 - 19. [Full Text] [PDF]

				J. Bruhn, P. S. Myles, R. Sneyd, and M. M. R. F. Struys Depth of anaesthesia monitoring: what's available, what's validated and what's next? Br. J. Anaesth., July 1, 2006; 97(1): 85 - 94. [Abstract] [Full Text] [PDF]

				C. Kerssens and P. S. Sebel To BIS or Not to BIS? That Is the Question Anesth. Analg., February 1, 2006; 102(2): 380 - 382. [Full Text] [PDF]

				R. D. Valley Awareness During Anesthesia in Children AAP Grand Rounds, May 1, 2005; 13(5): 56 - 57. [Full Text] [PDF]

				P. J. Davis Goldilocks: The Pediatric Anesthesiologist's Dilemma Anesth. Analg., March 1, 2005; 100(3): 650 - 652. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999