A comparative randomized study of awareness during two anesthetic induction techniques in old aged patients using isolated forearm technique | [Anaesthesia, Pain and Intensive Care • 2022]

Author(s):

1. Tamer Hamed Ibrahim: Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University,Cairo,Egypt

2. Ahmed H. Ayoub: Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University,Cairo,Egypt

3. Ibrahim Mohamed Ibrahim: Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University,Cairo,Egypt

4. Mohamed Abdulmohsen Abdulnaiem Ismaiel: Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University,Cairo,Egypt

5. Raham Hasan Mostafa: Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University,Cairo,Egypt

Abstract:

Background & Objective: Awareness under anesthesia is defined as intraoperative consciousness and/or postoperative recall of surgical events. The isolated forearm technique (IFT) is a technique that has the ability to assess consciousness of the external world through a verbal command during general anesthesia. It provides live information about the presence of consciousness. We compared inhalational induction technique versus intravenous induction technique regarding awareness during laryngoscopy and intubation in elderly patients. Design: A prospective, randomized trial Methodology: A total of 50 patients scheduled for elective surgery under general anesthesia; aged 60 to 80 years were recruited. Patients were randomized into either Group A (inhalational induction group) or Group B (total intravenous induction group). Awareness reaction using IFT technique was observed during laryngoscopy and intubation phase to identify awareness incidence. A patient was considered a responder if IFT score > 2. Results: At laryngoscopy and intubation phase, 32% of cases had an awareness reaction in intravenous induction group (Group B): While in the inhalational induction group (Group A), only 8% of cases had an awareness reaction. Additionally, none of the patients, suffered from postoperative explicit recall as detected by modified Brice questionnaire (MBQ). Conclusions: On the basis of the results of our study, we conclude that intravenous induction of general anesthesia may subject old aged patients to a higher incidence of awareness when compared to inhalational induction technique.

Page(s): 81-88

DOI: 10.35975/apic.v26i1.1772

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 26, Issue: 1, Year: 2022

Keywords:

Sevoflurane , Awareness , Elderly patients , TIVA , Isolated forearm technique , The modified Brice questionnaire

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