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  1. Widyastuti Y, Gentong M, Astuti W
    Med J Malaysia, 2020 05;75(Suppl 1):24-27.
    PMID: 32471966
    BACKGROUND: Procedural sedation and analgesia (PSAA) or monitoring anaesthesia care (MAC) must provide analgesia, amnesia and hypnosis with complete and rapid recovery that suits a particular operative procedure with minimum side effects. For a child undergoing a procedure, a major deciding factor is whether it is painful or not. Deep Sedation is required during the procedures to allay the anxiety, pain, and movement. The appropriate level of sedation depth will prevent consciousness, over-sedation, optimisation of dosage and prevents adverse complications. There are few studies about consciousness in pediatric patients during methotrexate injection with monitored anaesthesia care (MAC). The objective is to find out the incidence of consciousness of paediatric patients during methotrexate injection with Monitored Anaesthesia Care.

    METHODS: Observational study conducted on 68 patients (1- 18 yrs.) with physical status of ASA II during methotrexate injection with MAC at the RSUP dr. Sardjito. The depth of anaesthesia was monitored with Observer's Alertness Assessment Sedation Scale (OAAS) every two minutes. Consciousness was defined as OAAS=5, or if there is volunteer movement of patients. The result was analysed and categorised according to age, sex, physical status, Body Mass Index (BMI) and anaesthesia's medication of patients.

    RESULTS: Positive consciousness in paediatric patients based on OASS score at 2-minute and 4-minutes was 26.5% and 3.2% respectively, and was rescued by additional propofol 2mg/kg body weight.

    CONCLUSION: The incidence of paediatric consciousness in patients during methotrexate injection with Monitored Anaesthesia Care (MAC) in the Sardjito General Hospital is 26.5% (2-minute after induction) and 3.2% (4-minute after induction), and this is considerably high thus needing futher prevention.

    Matched MeSH terms: Consciousness/drug effects*
  2. Chang JJ, Syafiie S, Kamil R, Lim TA
    J Clin Monit Comput, 2015 Apr;29(2):231-9.
    PMID: 24961365 DOI: 10.1007/s10877-014-9590-6
    Anaesthesia is a multivariable problem where a combination of drugs are used to induce desired hypnotic, analgesia and immobility states. The automation of anaesthesia may improve the safety and cost-effectiveness of anaesthesia. However, the realization of a safe and reliable multivariable closed-loop control of anaesthesia is yet to be achieved due to a manifold of challenges. In this paper, several significant challenges in automation of anaesthesia are discussed, namely model uncertainty, controlled variables, closed-loop application and dependability. The increasingly reliable measurement device, robust and adaptive controller, and better fault tolerance strategy are paving the way for automation of anaesthesia.
    Matched MeSH terms: Consciousness/drug effects*
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