scholarly journals BIS-Guided Total Intravenous Anesthesia for Orchiopexy and Circumcision in a Child with Severe Autism: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Selçuk Okur ◽  
Müge Arıkan ◽  
Gülşen Temel ◽  
Volkan Temel
Keyword(s):  
Bispectral Index ◽  
Index System ◽  
Anesthetic Management ◽  
Hospital Setting ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Anesthetic Agents ◽  
Postanesthetic Care Unit ◽  
Severe Autism

Autistic children are very difficult to manage in the hospital setting because they react badly to any change in routine. We describe a case of 10-year-old male patient with severe autism undergoing orchidopexy and circumcision. Following premedication, anesthesia was induced with remifentanil, propofol, atracurium, and maintained with total intravenous anesthesia (propofol and remifentanil). The Bispectral Index System was monitored for determination of the depth of anesthesia. After surgery, all infusions were discontinued. The patient was then transferred to the postanesthetic care unit. There were no adverse events observed during the anesthetic management. The patient was discharged from the hospital on the second postoperative day. Bispectral Index System-guided Total Intravenous Anesthesia can provide some advantages for patient with autism, such as hemodynamic stability, early and easy recovery, to facilitate faster discharge, to optimize the delivery of anesthetic agents, to minimize its adverse effects, and to maximize its safety.

scholarly journals Comparative Evaluation of a New Depth of Anesthesia Index in ConView® System and the Bispectral Index during Total Intravenous Anesthesia: A Multicenter Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yang Fu ◽  
Tao Xu ◽  
Keliang Xie ◽  
Wei Wei ◽  
Ping Gao ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Bispectral Index ◽  
Mean Value ◽  
Total Intravenous Anesthesia ◽  
Depth Of Anesthesia ◽  
Clinical Trial Registry ◽  
Intravenous Anesthesia ◽  
Spectral Edge Frequency ◽  
Prediction Probability ◽  
Conscious Level

The performance of a new monitor for the depth of anesthesia (DOA), the Depth of Anesthesia Index (Ai) based on sample entropy (SampEn), 95% spectral edge frequency (95%SEF), and burst suppression ratio (BSR) was evaluated compared to Bispectral Index (BIS) during total intravenous anesthesia (TIVA). 144 patients in six medical centers were enrolled. General anesthesia was induced with stepwise-increased target-controlled infusion (TCI) of propofol until loss of consciousness (LOC). During surgery propofol was titrated according to BIS. Both Ai and BIS were recorded. Primary outcomes: the limits of agreement between Ai and BIS were -17.68 and 16.49, which were, respectively, -30.0% and 28.0% of the mean value of BIS. Secondary outcomes: prediction probability (Pk) of BIS and Ai was 0.943 and 0.935 (p=0.102) during LOC and 0.928 and 0.918 (p=0.037) during recovery of consciousness (ROC). And the values of BIS and Ai were 68.19 and 66.44 at 50%LOC, and 76.65 and 78.60 at 50%ROC. A decrease or an increase of Ai was significantly greater than that of BIS when consciousness changes (during LOC: -9.13±10.20 versus -5.83±9.63, p<0.001; during ROC: 10.88±11.51 versus 5.32±7.53, p<0.001). The conclusion is that Ai has similar characteristic of BIS as a DOA monitor and revealed the advantage of SampEn for indicating conscious level. This trial is registered at Chinese Clinical Trial Registry with ChiCTR-IOR-16009471.

scholarly journals Total Intravenous Anesthesia in Neurosurgery

2018 ◽  
Vol 05 (03) ◽  
pp. 141-149 ◽  
Author(s):  
Narmadhalakshmi Kannabiran ◽  
Prasanna Udupi Bidkar
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Anesthetic Agents ◽  
Nociceptive Stimulus ◽  
Neurosurgical Patients ◽  
Effect Site Concentration ◽  
Safe Anesthesia ◽  
Infusion Technique ◽  
Rapid Emergence

AbstractIn recent years, neurosurgical anesthesia has been rapidly evolving in the fields of pharmacotherapy and techniques to administer safe anesthesia. Intravenous (IV) anesthetic agents reduce both cerebral blood flow and intracranial pressure besides maintaining flow–metabolism coupling in contrast to inhalational agents. In neuroanesthesia, the technique and choice of drugs directly influence the outcome of the patients. The purpose of this review is to provide the updated information of total intravenous anesthesia (TIVA) in neuroanesthesia. Administration of TIVA using target-controlled infusion technique is emerging as a standard method to administer safe anesthesia in neurosurgical patients. The propofol–remifentanil combination has become very popular due to their favorable pharmacokinetic and pharmacodynamic properties for neurosurgery cases. Plasma-effect site concentration monitoring from target TCI devices together with electroencephalogram or bispectral index monitors allows easy titration of anesthetic agents to ensure adequate depth of anesthesia depending upon the nociceptive stimulus. TIVA is associated with smooth induction and rapid emergence with less postoperative nausea and vomiting.

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