![]() ![]() Thus, during short surgical procedures where these factors are under controlled conditions, fluctuations in end-tidal oxygen concentration (EtO 2%) under anaesthesia could be translated to increased cerebral oxygen consumption due to light plane of anaesthesia. Under static anaesthetic conditions of immobility, fixed inspired oxygen concentration, fixed inspired anaesthetic agent concentration and use of muscle relaxation, oxygen consumption depends on other factors such as pain, age, temperature and haematocrit. ![]() This has been elicited in various studies using cerebral oximetry by the method of near-infrared spectroscopy (NIRS). Hence, a deeply anaesthetised patient will have a decreased rate of oxygen consumption, whereas lighter planes of anaesthesia will increase the cerebral oxygen consumption. ![]() Inhalational anaesthetics decrease the cerebral metabolic rate and cerebral oxygen consumption. We hypothesised that ETAG for sevoflurane (ETAG-sevo) would not correlate with values of BIS in very young children. However, due to the rapidly developing infant and toddler brain and increased neuronal synaptic activity, its use in children is controversial. Bispectral index (BIS) monitoring, which is based on an algorithm developed from adult electroencephalogram (EEG) values, is being used to measure anaesthetic depth in adults. Measurement of end-tidal anaesthetic gas concentrations (ETAGs) provides real-time feedback and facilitates target-controlled titration of volatile anaesthetic agent administration and is currently a pragmatic indicator for monitoring anaesthetic depth. This is a further justification for needing to know the level of anaesthetic depth in paediatric patients. ![]() In December 2016, the Food and Drug Administration of USA issued a 'Drug Safety Communication' warning for administering of general anaesthetic and sedation drugs in children aged <3 years which can affect brain development. Moreover, preverbal children cannot express the intraoperative recall of events which may be well-elicited in adults. The incidence of awareness during anaesthesia in children has been reported to be four to eight times higher than in adults. Awareness during surgery is undesirable and has long-term behavioural and psychological effects. ![]()
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