Sedation monitoring during open muscle biopsy in children by Comfort Score and Bispectral Index - a prospective analysis

2014 ◽  
Vol 25 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Eva Tschiedel ◽  
Oliver Müller ◽  
Ulrike Schara ◽  
Ursula Felderhoff-Müser ◽  
Christian Dohna-Schwake
Keyword(s):  
Muscle Biopsy ◽  
Bispectral Index ◽  
Prospective Analysis ◽  
Sedation Monitoring ◽  
Open Muscle

The Influence of BIS Monitoring on Sedative Dose in Pediatric Patients Undergoing Open Muscle Biopsies – a Randomized Controlled Trial

2017 ◽  
Vol 230 (02) ◽  
pp. 68-72 ◽  
Author(s):  
Eva Tschiedel ◽  
Oliver Müller ◽  
Adela Marina ◽  
Ursula Felderhoff-Müser ◽  
Christian Dohna-Schwake
Keyword(s):  
Muscle Biopsy ◽  
Pediatric Patients ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Sedation Monitoring ◽  
Eye Opening ◽  
Open Muscle ◽  
The Impact ◽  
Muscle Biopsies ◽  
Sedative Dose

Abstract Background The use of Propofol and Remifentanil for analgosedation in children is common and safe. For sedation monitoring clinical scores as Comfort Score (CS) as well as bispectral index (BIS) are frequently applied. The impact of BIS for sedation monitoring in pediatric patients is still under debate. This prospective study aims to investigate whether dual sedation monitoring of CS and BIS compared with monitoring of CS alone during muscle biopsies in children can reduce sedative doses, reduce awakening time and prevent complications. Methods 50 pediatric patients requiring sedation for open muscle biopsy were prospectively enrolled. Analgosedation was performed with remifentanil and propofol. Patients were randomly assigned to 2 groups: In 25 patients, sedation was monitored using CS alone, and in 25 patients CS and BIS monitoring were simultaneously applied. The primary outcome was the propofol dose applied during muscle biopsy. Secondary outcome parameters were recovery time and the frequency of complications. Results The median CS during the intervention in both groups was equal (11, P=1.000). The median BIS in group 2 was 59. No complications occurred in either group. There was no difference in propofol dose in either group (8.4 vs. 7.2 mg/kg/h; P=0.58) and no difference in the duration until eye opening (9 vs. 11 min; P=0.081). Conclusion For children undergoing minor surgical procedures under analgosedation, BIS monitoring does not affect the sedative dose, the time until eye opening or the frequency of complications.

AB1118 OPEN MUSCLE BIOPSY AS A SAFE AND USEFUL MEANS OF DIAGNOSING VASCULITIS: A SINGLE-CENTER EXPERIENCE OF 210 BIOPSY CASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.1-1848
Author(s):  
T. Mori ◽  
N. Yokogawa ◽  
K. Shimada
Keyword(s):  
Adverse Events ◽  
Muscle Biopsy ◽  
Safety Profile ◽  
Granulomatosis With Polyangiitis ◽  
Wound Dehiscence ◽  
Antiplatelet Drugs ◽  
Surgical Removal ◽  
Diagnostic Utility ◽  
Open Muscle ◽  
Muscle Biopsies

Background:We previously reported the utility of open muscle biopsies in diagnosing vasculitis [1]. The number of open muscle biopsies performed at our department has increased to over 200. The purpose of the present study was to evaluate the diagnostic utility of vasculitis and the safety of the open muscle biopsies.Objectives:To clarify the diagnostic utility of vasculitis and the safety profile of the open muscle biopsy.Methods:We retrospectively examined all cases of open muscle biopsy performed between May 2012 and June 2018 in our department. The biopsy results, the presence or absence of adverse events, and blood test data at the time of the biopsy were extracted from the patients’ electronic medical records.Results:Between May 2012 and June 2018, 210 open muscle biopsies were performed, 120 of which were done for vasculitis diagnosis. Diagnostic histopathological findings were obtained in 42 of the 120 cases (35%). The definitive diagnosis in these cases was microscopic polyangiitis (30 cases), eosinophilic granulomatosis with polyangiitis (seven cases), granulomatosis with polyangiitis (one case), polyarteritis nodosa (three cases), and other vasculitis (one case). In 57 cases with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) ≥ 10 U/ml, 31 cases (54.3%) showed histopathology of vasculitis. In six cases with protainase-3-ANCA (PR3-ANCA) ≥ 10 U/ml, histopathology of vasculitis was found in one case (16.7%).In all 210 open muscle biopsy cases, complications included minor wound dehiscence (11 cases) and small subcutaneous hematoma (six cases), which were able to be managed by local treatment. Albumin was significantly lower in the patients with wound dehiscence (mean 3.2 vs 2.7, p = 0.049)Serious complications included anaphylaxis due to local anesthesia (one case), compartment syndrome due to hematoma (one case), hematoma requiring surgical removal (one case), and arterial hemorrhage requiring surgical intervention (one case). The patients in the latter three hemorrhagic cases were receiving antiplatelet drugs.Conclusion:An open muscle biopsy is useful for diagnosing vasculitis, especially for MPO-ANCA-positive anca-associated vasculitis. Its safety profile is acceptable. Serious adverse events are rare, but the procedure should be performed carefully when patients are receiving antiplatelet drugs.References:[1]Nunokawa T. et al. The use of muscle biopsy in the diagnosis of systemic vasculitis affecting small to medium-sized vessels: A prospective evaluation in Japan. Scand. J. Rheumatol. 2016;45:210–214Disclosure of Interests:None declared

Role of the Bispectral Index in Sedation Monitoring in the ICU

2006 ◽  
Vol 40 (3) ◽  
pp. 490-500 ◽  
Author(s):  
Jaclyn M LeBlanc ◽  
Joseph F Dasta ◽  
Sandra L Kane-Gill
Keyword(s):  
Bispectral Index ◽  
Sedation Monitoring

Laser Doppler blood flow studies during open muscle biopsy in patients with neuromuscular diseases

Neurology ◽  
1983 ◽  
Vol 33 (5) ◽  
pp. 547-547 ◽  
Author(s):  
A. J. Tahmoush ◽  
P. D. Bowen ◽  
R. F. Bonner ◽  
T. J. Mancini ◽  
W. K. Engel
Keyword(s):  
Blood Flow ◽  
Muscle Biopsy ◽  
Neuromuscular Diseases ◽  
Laser Doppler ◽  
Open Muscle

scholarly journals Impact of Propofol Bolus Administration on the Nociceptive Flexion Reflex Threshold and Bispectral Index in Children—A Case Series

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 639
Author(s):  
Maximilian David Mauritz ◽  
Felix Uhlenberg ◽  
Eik Vettorazzi ◽  
Chinedu Ulrich Ebenebe ◽  
Dominique Singer ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Case Series ◽  
Bolus Administration ◽  
Endotracheal Suctioning ◽  
Flexion Reflex ◽  
Nociceptive Flexion Reflex ◽  
Continuous Sedation ◽  
Sedation Monitoring ◽  
Reflex Threshold ◽  
The Impact

We analyzed the impact of propofol administration during continuous sedation and analgesia on the nociceptive flexion reflex threshold (NFRT) and Bispectral Index (BIS) in ventilated children. We examined patients who received propofol before planned endotracheal suctioning. Patients were clinically assessed using the modified Face, Legs, Activity, Cry, Consolability (mFLACC) scale and COMFORT-B (Comfort Behavior) scale. We continuously recorded the NFRT and BIS. We recorded 23 propofol administrations in eight patients with an average age of 8.6 ± 3.5 years. The median (minimum-maximum) scores for the mFLACC scale and COMFORT-B scale were 0 (0–5) and 6 (6–17), respectively, before the bolus. The administration of a weight-adjusted propofol bolus of 1.03 ± 0.31 mg/kg resulted in an increase in NFRT and burst-suppression ratio; BIS and electromyogram values decreased. Changes from baseline (95% CI) after propofol bolus administration were BIS −23.9 (−30.8 to −17.1), EMG -10.5 dB (−13.3 to −7.7), SR 14.8 % (5.6 to 24.0) and NFRT 13.6 mA (5.5 to 21.7). Further studies are needed to determine whether sedated children may benefit from objective pain and sedation monitoring with BIS and NFRT.

Open muscle biopsy

2002 ◽  
Vol 4 (3) ◽  
pp. 235-238 ◽  
Author(s):  
Jeromy Brink
Keyword(s):  
Muscle Biopsy ◽  
Open Muscle

scholarly journals Differences in pain perception during open muscle biopsy and Bergstroem needle muscle biopsy

2014 ◽  
pp. 645 ◽  
Author(s):  
Julius Dengler ◽  
Peter Linke ◽  
Hans J. Gdynia ◽  
Stefan Wolf ◽  
Albert C. Ludolph ◽  
...  
Keyword(s):  
Muscle Biopsy ◽  
Pain Perception ◽  
Open Muscle

Open muscle biopsy in suspected myopathy: diagnostic yield and clinical utility

2009 ◽  
Vol 17 (1) ◽  
pp. 136-142 ◽  
Author(s):  
C.-H. Lai ◽  
G. Melli ◽  
Y.-J. Chang ◽  
R. L. Skolasky ◽  
A. M. Corse ◽  
...  
Keyword(s):  
Muscle Biopsy ◽  
Clinical Utility ◽  
Diagnostic Yield ◽  
Open Muscle
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