A high proportion of survey respondents were willing to undergo repeat PNB in case of future surgery and were satisfied with their anesthetic care. Targeted interventions to improve quality of PNB should be aimed at improving comfort, information provision, and physician-patient interaction.
SummaryFive recent cohort studies have shown a frequency of awareness in paediatric anaesthesia of between 0.2% and 1.2%, but they were not individually large enough to identify risk factors. This study pooled raw data from these five studies to identify factors associated with awareness in children. The outcome of awareness was taken as the cases judged to be most likely awareness cases in each study. Logistic regression was used to identify awareness-associated factors. A combined sample of 4486 anaesthetics revealed 33 cases of awareness. Unadjusted analysis demonstrated weak evidence that nitrous oxide used as an anaesthetic maintenance adjunct was associated with awareness (OR 2.04 (95% CI 0.97-4.33), p = 0.06), and some evidence that use of a tracheal tube was associated with awareness (OR 2.78 (95% CI 1.11-6.94), p = 0.03). Multivariable regression analysis revealed that nitrous oxide maintenance and use of a tracheal tube were independently associated with awareness (nitrous oxide, OR 2.4 (95% CI 1.08-5.32), p = 0.03; tracheal tube, OR 3.0 (95% CI 1.20-7.56), p = 0.02).
Caudal blockade decreased the degree of arousal, as measured by BIS, in unstimulated children aged 2-5 years. No change in arousal was detected in infants.
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