Novel Approach for Studying Cognitive Profiles of Sedatives in Children

"Objectives:" To compare cognitive effects of nitrous oxide and midazolam in children using computerised battery systems."Methods:"Randomised, controlled, cross-over clinical trial. 40 subjects, age 10-16years, ASA I and II, requiring orthodontic extractions bilaterally, under sedation. Random allocation for treatment under inhalation sedation on one visit for one side and oral midazolam for the other. On each visit patients perform computerised tests to determine baseline and postoperative cognitive performance. These tests are programmed on computerised battery wristwatches called Cogniwatches and a laptop computer. The Cogniwatches are worn by the patients and taken home to perform tests up to 6 hour postoperatively. Cogniwatches measure effects of sedative drugs on attention by testing simple reaction time, choice reaction time and digit vigilance. A two-button response system set in the watch records 'Yes' and 'No' responses. The laptop test system includes a number of measures specific to particular aspects of attention, working memory (spatial working memory and immediate word recall) and long-term memory (picture recognition, word recognition and delayed word recall). There is also a computerised version of Visual Analogue Scales on the laptop measuring the effects on mood. The laptop tests are performed in the dental surgery."Results:" This presentation will introduce a novel method for studying the cognitive profiles of sedative drugs in children by using computerised wristwatches i.e. Cogniwatches. Data from the computerised battery systems will be downloaded on to a PC and analysed using parametric methods to determine any differences between cognitive profiles of nitrous oxide and oral midazolam. "Conclusion:" Automated cognitive testing is highly sensitive, objective and accurate in measuring the cognitive profiles of drugs and has established validity and reliability compared to traditional pencil and paper methods. An additional advantage of Cogniwatch is that it can be taken home and used to measure cognitive effects over a period of time.