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Title: Connected consciousness after tracheal intubation in young adults: an international multicentre cohort study
Authors: Lennertz, Richard
Pryor, Kane O
Raz, Aeyal
Parker, Maggie
Bonhomme, Vincent
Schuller, Peter
Schneider, Gerhard
Moore, Matt
Coburn, Mark
Root, James C
Emerson, Jacqueline M
Hohmann, Alexandra L
Azaria, Haya
Golomb, Neta
Defresne, Aline
Montupil, Javier
Pilge, Stefanie
Obert, David P
van Waart, Hanna
Seretny, Marta
Rossaint, Rolf
Kowark, Ana
Blair, Alexander
Krause, Bryan
Proekt, Alex
Kelz, Max
Sleigh, Jamie
Gaskell, Amy
Sanders, Robert D
Issue Date: 2022
Publisher: Elsevier
Source: Lennertz R, Pryor KO, Raz A, Parker M, Bonhomme V, Schuller P, Schneider G, Moore M, Coburn M, Root JC, Emerson JM, Hohmann AL, Azaria H, Golomb N, Defresne A, Montupil J, Pilge S, Obert DP, van Waart H, Seretny M, Rossaint R, Kowark A, Blair A, Krause B, Proekt A, Kelz M, Sleigh J, Gaskell A, Sanders RD. Connected consciousness after tracheal intubation in young adults: an international multicentre cohort study. Br J Anaesth. 2022 May 18:S0007-0912(22)00192-1. doi: 10.1016/j.bja.2022.04.010. Epub ahead of print. PMID: 35618535.
Journal: British journal of anaesthesia
Abstract: Connected consciousness, assessed by response to command, occurs in at least 5% of general anaesthetic procedures and perhaps more often in young people. Our primary objective was to establish the incidence of connected consciousness after tracheal intubation in young people aged 18-40 yr. The secondary objectives were to assess the nature of these responses, identify relevant risk factors, and determine their relationship to postoperative outcomes. This was an international, multicentre prospective cohort study using the isolated forearm technique to assess connected consciousness shortly after tracheal intubation. Of 344 enrolled subjects, 338 completed the study (mean age, 30 [standard deviation, 6.3] yr; 232 [69%] female). Responses after intubation occurred in 37/338 subjects (11%). Females (13%, 31/232) responded more often than males (6%, 6/106). In logistic regression, the risk of responsiveness was increased with female sex (odds ratio [ORadjusted]=2.7; 95% confidence interval [CI], 1.1-7.6; P=0.022) and was decreased with continuous anaesthesia before laryngoscopy (ORadjusted=0.43; 95% CI, 0.20-0.96; P=0.041). Responses were more likely to occur after a command to respond (and not to nonsense, 13 subjects) than after a nonsense statement (and not to command, four subjects, P=0.049). Connected consciousness occured after intubation in 11% of young adults, with females at increased risk. Continuous exposure to anaesthesia between induction of anaesthesia and tracheal intubation should be considered to reduce the incidence of connected consciousness. Further research is required to understand sex-related differences in the risk of connected consciousness.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Peter Schuller
DOI: 10.1016/j.bja.2022.04.010
Keywords: awareness;consciousness;general anaesthesia;isolated forearm technique;memory;recall;sex;tracheal intubation
Type: Article
Appears in Sites:Cairns & Hinterland HHS Publications

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