Awareness in Old Aged Patients During Laryngoscopy and Intubation Using Isolated Forearm Technique

Detection of Responsiveness and Awareness in Old Aged Patients During Laryngoscopy and Intubation Using Isolated Forearm Technique

Awareness during general anesthesia - that has an incidence between 0.1% and 0.9% of cases and may be more in elderly - remains a concern for anesthesiologists. Awareness experiences range from isolated auditory perceptions to reports of a patient being fully awake, immobilized, and in pain. The isolated forearm technique allows assessment of consciousness of the external world (connected consciousness) through a verbal command to move the hand (of a tourniquet-isolated arm) during intended general anesthesia.

Objective: To compare inhalational induction versus intravenous induction regarding awareness during laryngoscopy and intubation in elderly patients undergoing day case elective surgery.

Inclusion Criteria:

• 50 American society of anesthesiologists- Physical status (ASA-PS) I and II patients,
• aged 60 to 80 years,
• 70-80 kg,
• both sexes,
• with intact hearing,
• undergoing elective day case surgery were included in the study.

Exclusion Criteria:

1. Uncooperative patients,
2. Language barrier problems,
3. Psychological disorders,
4. Suspected difficult intubation,
5. History of awareness under anesthesia,
6. History of substance abuse,
7. The inability to have tourniquet on arm for the IFT (e.g., lymphedema or operative site)
8. Neuromuscular disorders.
9. Advanced renal, hepatic, cardiac, respiratory or neurological dysfunction
10. If rapid sequence induction was indicated (not suitable for inhalation induction).