DETECTING WAKEFULNESS IN ANESTHETIZED CHILDREN

Purpose: To investigate the suitability of the isolated forearm techni que in detecting wakefulness in children aged 5 to 16 yr. Methods: For ty-one healthy English speaking children were enrolled. Following intr avenous induction of anaethesia with 5-7 mg.kg(-1) thiopentone iv, but before administration of 1-1.5 mg.kg(-1) succinylcholine pneumatic to urniquet was inflated to 50 mmHg above systolic pressure in order to i solate the non-cannulated forearm. Thereafter, anaesthesia was maintai ned with halothane 1.5-2.5% in nitrous oxide and oxygen. Following the muscle relaxant the patient was instructed to move the unparalyzed ar m, Movement was checked al 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 re spond was five years old. Conclusion: The isolated forearm technique c an be used to detect wakefulness during and immediately following trac heal intubation in children from the age of five years.