Article (Scientific journals)
Connected consciousness after tracheal intubation in young adults: an international multicentre cohort study
Lennertz, Richard; Pryor, Kane; Raz, Aeyal et al.
2022In British Journal of Anaesthesia
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Abstract :
[en] Background: 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 18e40 yr. The secondary objectives were to assess the nature of these responses, identify relevant risk factors, and determine their relationship to postoperative outcomes. Methods: This was an international, multicentre prospective cohort study using the isolated forearm technique to assess connected consciousness shortly after tracheal intubation. Results: 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 [OR adjusted ]¼2.7; 95% confidence interval [CI], 1.1e7.6; P¼0.022) and was decreased with continuous anaesthesia before laryngoscopy (OR adjusted ¼0.43; 95% CI, 0.20e0.96; P¼0.041). 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, P¼0.049). Conclusions: 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
Disciplines :
Anesthesia & intensive care
Author, co-author :
Lennertz, Richard;   Department of Anesthesiology, University of Wisconsin, Madison, USA
Pryor, Kane;   Department of Anesthesiology, Weill Cornell Medicine, New York, USA
Raz, Aeyal;   Department of Anesthesiology, Rambam Health Care Center
Parker, Maggie;   Department of Anesthesiology, University of Wisconsin, Madison, USA
BONHOMME, Vincent  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Schuller, Peter;   Department of Anaesthesia, Cairns Hospital, Australia
Schneider, Gerhard;   School of Medicine, Department of Anaesthesiology and Intensive Care, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
Moore, Matt;   Department of Anesthesiology, University of Auckland, Auckland
Coburn, Mark;   Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
Root, James;   Department of Anesthesiology, Weill Cornell Medicine, New York, USA ; Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
Emerson, Jacqueline;   Department of Anesthesiology, Weill Cornell Medicine, New York, USA
Hohmann, Alexandra;   Department of Anesthesiology, Weill Cornell Medicine, New York, USA
Azaria, Haya;   Department of Anesthesiology, Rambam Health Care Center
Golomb, Neta;   Department of Anesthesiology, Rambam Health Care Center
DEFRESNE, Aline  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Montupil, Javier ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Pilge, Stefanie;   School of Medicine, Department of Anaesthesiology and Intensive Care, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
Obert, David;   School of Medicine, Department of Anaesthesiology and Intensive Care, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
Van Waart, Hanna;   Department of Anesthesiology, University of Auckland, Auckland
Seretny, Marta;   Department of Anesthesiology, University of Auckland, Auckland
Rossaint, Rolf;   Department of Anesthesiology, Medical Faculty University Hospital RWTH Aachen, Aachen, Germany
Kowark, Ana;   Department of Anesthesiology, Medical Faculty University Hospital RWTH Aachen, Aachen, Germany
Blair, Alexander;   Department of Anesthesiology, University of Wisconsin, Madison, USA
Krause, Bryan;   Department of Anesthesiology, University of Wisconsin, Madison, USA
Proekt, Alex;   Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, USA
Kelz, Max;   Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, USA
Sleigh, Jamie;   Department of Anaesthesiology, Waikato Clinical Campus, 13 Specialty of Anaesthetics, University of Auckland, Hamilton ; University of Sydney, Camperdown, Australia
Gaskell, Amy;   Department of Anaesthesiology, Waikato Clinical Campus, 13 Specialty of Anaesthetics, University of Auckland, Hamilton ; University of Sydney, Camperdown, Australia
Sanders, Robert;   Department of Anaesthetics and Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
More authors (19 more) Less
Language :
English
Title :
Connected consciousness after tracheal intubation in young adults: an international multicentre cohort study
Publication date :
2022
Journal title :
British Journal of Anaesthesia
ISSN :
0007-0912
eISSN :
1471-6771
Publisher :
Elsevier, London, United Kingdom
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 24 June 2022

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