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A research tool for measurement of recovery from sedation: The vancouver sedative recovery scale

  • Andrew J. Macnab
    Correspondence
    Address reprint requests to Andrew J. Macnab, MD, Division of Paediatric Intensive Care, British Columbia's Children's Hospital, 4480 Oak St, Vancouver, British Columbia V6H 3V4 Canada.
    Affiliations
    Division of Paediatric Intensive Care, British Columbia's Children's Hospital, Vancouver, British Columbia Canada

    Faculties of Medicine and Pharmaceutical Sciences, and the Departments of Statistics and Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia Canada

    the Departments of Medicine and Pharmacy, University Hospital (Shaughnessy Site), Vancouver, British Columbia Canada

    Susak Medical Research Associates, Vancouver, British Columbia Canada
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  • Marc Levine
    Affiliations
    Division of Paediatric Intensive Care, British Columbia's Children's Hospital, Vancouver, British Columbia Canada

    Faculties of Medicine and Pharmaceutical Sciences, and the Departments of Statistics and Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia Canada

    the Departments of Medicine and Pharmacy, University Hospital (Shaughnessy Site), Vancouver, British Columbia Canada

    Susak Medical Research Associates, Vancouver, British Columbia Canada
    Search for articles by this author
  • Ned Glick
    Affiliations
    Division of Paediatric Intensive Care, British Columbia's Children's Hospital, Vancouver, British Columbia Canada

    Faculties of Medicine and Pharmaceutical Sciences, and the Departments of Statistics and Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia Canada

    the Departments of Medicine and Pharmacy, University Hospital (Shaughnessy Site), Vancouver, British Columbia Canada

    Susak Medical Research Associates, Vancouver, British Columbia Canada
    Search for articles by this author
  • Lark Susak
    Affiliations
    Division of Paediatric Intensive Care, British Columbia's Children's Hospital, Vancouver, British Columbia Canada

    Faculties of Medicine and Pharmaceutical Sciences, and the Departments of Statistics and Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia Canada

    the Departments of Medicine and Pharmacy, University Hospital (Shaughnessy Site), Vancouver, British Columbia Canada

    Susak Medical Research Associates, Vancouver, British Columbia Canada
    Search for articles by this author
  • Gloria Baker-Brown
    Affiliations
    Division of Paediatric Intensive Care, British Columbia's Children's Hospital, Vancouver, British Columbia Canada

    Faculties of Medicine and Pharmaceutical Sciences, and the Departments of Statistics and Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia Canada

    the Departments of Medicine and Pharmacy, University Hospital (Shaughnessy Site), Vancouver, British Columbia Canada

    Susak Medical Research Associates, Vancouver, British Columbia Canada
    Search for articles by this author
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      Abstract

      The need for a research tool to measure recovery from sedation was identified during the design phase of a study investigating sedative protocols following open heart surgery in children. A thorough review of the literature failed to show any scales that measure degree of sedation in children at various times after initial awakening. The Vancouver Sedative Recovery Scale (VSRS) was developed through an iterative process during which we identified numerous indicators of levels of alertness among sedated children, and then determined the applicability and face validity of these indicators. The VSRS evaluated in this study consists of 12 distinct items that encompass three categories of indicators (response; eye appearance and function; and body movement). Total possible VSRS scoring ranges from 0 to 22 (higher score indicating more alert) because some of the 12 items have more than two rating levels. The VSRS was administered to 82 pediatric intensive care unit and postanesthesia recovery patients, with each patient assessed simultaneously by at least two observers. Internal consistency as measured by Cronbach's α was excellent: 0.85. Interobserver agreement or reliability as measured by intraclass correlation was also very high: 0.90; and for individual items Cohen's κ ranged from 0.65 to 0.89. We consider the VSRS to be a good beginning in our effort to quantify level of alertness after sedation in the pediatric patient population.

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