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Detecting awareness during general anaesthetic Caesarean section An evaluation of two methods
Author(s) -
BOGOD D. G.,
ORTON J. K.,
YAU H. M.,
OH T. E.
Publication year - 1990
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1990.tb14732.x
Subject(s) - medicine , general anaesthesia , caesarean section , anesthesia , general anaesthetic , contractility , forearm , surgery , pregnancy , biology , genetics
Summary Seventy ‐four patients received general anaesthesia for Caesarean section. Seven percent of the elective group and 28% of the emergency patients reported dreaming or recall of voices during the procedure (p < 0.05) at postoperative interview. One patient from each group reported feeling pain or suffocation. All patients were monitored for awareness using the isolated forearm technique and lower oesophageal contractility. Provoked lower oesophageal contractility was the most effective of the different indices. A value greater than 35 mmHg on at least one occasion had a false negative rate of 33%, a false positive rate of 28% and a predictive value of 25%. A value greater than 13 mmHg picked up all patients who dreamed, with a false positive rate of 68%. Both of the ‘aware’patients had provoked lower oesophageal contractility response of greater than 70 mmHg, an attribute shared by only 8% of the rest. The isolated forearm was particularly ineffective.