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 Effect of Bispectral Index-Guided Total Intravenous Anesthesia on Post-Anesthetic Recovery Outcomes in High-Risk Children: A Prospective, Randomized, Controlled Trial

2021 ◽  
Author(s):  
Guoliang Liu ◽  
Lijing Li ◽  
Xuemei Zhang ◽  
Xiaoxue Wang ◽  
Lei Hua ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Bispectral Index ◽  
Controlled Trial ◽  
Total Intravenous Anesthesia ◽  
Depth Of Anesthesia ◽  
Intravenous Anesthesia ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Group B

Abstract BACKGROUND TIVA is widely used in children, but few studies have attempted to evaluation of the effect of BIS-guided propofol infusion than that on conventional methods on recovery outcomes in children with higher risk factors.OBJECTIVETo evaluate the effect of bispectral index (BIS) guidance during total intravenous anesthesia on post-anesthetic recovery outcomes in children at higher risk during anesthesia. DESIGNA prospective, randomized, controlled trial. SETTING University medical centre.PATIENTSThis study enrolled 472 children (aged 1-14 years) who met the higher-risk scoring criteria and were scheduled for surgery under total intravenous anesthesia. INTERVENTIONThe children were randomly assigned to the BIS group (group B) and standard clinical practice group (group S). The BIS values in group B were maintained at 45–60. The anesthesiologist controlled the depth of anesthesia in group S according to the variation in the clinical signs of the children. MAIN OUTCOME MEASURESBIS values, heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation at each time points, as well as the time between drug withdrawal to extubation, duration of stay in the post-anesthesia care unit (PACU), the total amount of propofol used, and postoperative adverse reactions were recorded. RESULTSThere was no significant difference in time from stopping propofol infusion to extubation and duration of PACU between the groups . There was no significant difference in BIS values between the groups at T2, T3, and T8. BIS values at T1, T4, T5, T6, and T7 in group B were lower than those in group S. There was no statistically significant difference in the HR between the groups. MAP in group B was lower than in group S at T5, T6, T7, and T8. The total amount of propofol administered in group B was higher than in group S. CONCLUSIONThe use of BIS-guided total intravenous anesthesia in higher-risk children can maintain the proper depth of anesthesia but does not prolong the time of extubation and the duration of stay in the PACU.TRIAL REGISTRATION Chictr.org.cn identifier: 24/11/2017 , ChiCTR-IOR-17013530

scholarly journals Variability of anesthetic depth in total intravenous anesthesia vs balanced anesthesia using entropy indices: a randomized, crossover, controlled clinical trial

2020 ◽  
Vol 48 (3) ◽  
pp. 111-117
Author(s):  
Henry Oliveros ◽  
Fernando Ríos ◽  
Daniel A. Botero-Rosas ◽  
Sandra C. Quiroga ◽  
Freddy C. Cifuentes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Total Intravenous Anesthesia ◽  
Controlled Clinical Trial ◽  
Anesthetic Techniques ◽  
Depth Of Anesthesia ◽  
Minimal Alveolar Concentration ◽  
Intravenous Anesthesia ◽  
Significant Difference ◽  
Balanced Anesthesia ◽  
The Individual

Introduction: Total intravenous anesthesia (TIVA) and balanced anesthesia (BA) are the most commonly used anesthetic techniques. The differences are the variability of the depth of anesthesia between these techniques that might predict which one is safer for patients and presents a lower risk of intraoperative awakening. Objective: To determine whether a difference exists in the variability of depth of anesthesia obtained by response entropy (RE).  Methods: A crossover clinical trial was conducted on 20 healthy patients receiving upper or lower limb ambulatory orthopedic surgery. Patients were randomly assigned to (a) target-controlled infusion of propofol using the Schnider model at a target concentration of 2.5mg/mL for 15minutes and a 10-minute washout, followed by sevoflurane administration at 0.8 minimal alveolar concentration (MAC) for the reminder of the surgery, or (b) the reverse sequence. Differences in the variability of the depth of anesthesia using RE were evaluated using paired t test. Results: The treatment effect showed no significant difference in the average values of RE, during TIVA=97.23 vs BA 97.04 (P=0.39). Carry Over (-4.98 vs 4.08) and Period (100.3 vs 94.68) effects were not significantly different. Conclusion: The present study suggests that both anesthetic techniques are equivalent in terms of the stability of the depth of anesthesia. It is important to keep testing the determinants of the efficacy of different populations because the individual behaviors of patients might ultimately tip the scale.

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 Spectral Entropy as a Measure of Hypnosis and Hypnotic Drug Effect of Total Intravenous Anesthesia in Children during Slow Induction and Maintenance

2012 ◽  
Vol 116 (2) ◽  
pp. 340-351 ◽  
Author(s):  
Jaakko G. M. Klockars ◽  
Arja Hiller ◽  
Sinikka Münte ◽  
Mark J. van Gils ◽  
Tomi Taivainen
Keyword(s):  
Drug Effect ◽  
Age Groups ◽  
Total Intravenous Anesthesia ◽  
Healthy Children ◽  
Spectral Entropy ◽  
Intravenous Anesthesia ◽  
Hypnotic Drug ◽  
Target Controlled Infusion ◽  
Prediction Probability ◽  
The University

Background We evaluated whether spectral entropy (SpE) can measure the depth of hypnosis and the hypnotic drug effect in children during total intravenous anesthesia. Methods Sixty healthy children, aged 3-16 yr, were studied. Anesthesia was induced with an increasing target controlled infusion of propofol, and maintained by a stable remifentanil infusion and variable concentrations of target controlled infusion propofol. Depth of hypnosis was assessed according to the University of Michigan Sedation Scale (UMSS). Estimated plasma (C(p)) and pseudo effect site (C(eff)) propofol concentrations reflected the hypnotic drug effect. Patients were stratified to three age groups. The correlations between SpE versus UMSS, C(p), and C(eff) were analyzed by Prediction Probability (P(k)). The pharmacodynamic relationship between SpE and C(p), and the differences of SpE values between the age groups at the corresponding UMSS levels, were studied. Results Respective mean P(k) values for the youngest, middle, and oldest age groups were: 1) during induction: SpE versus UMSS 0.87, 0.87, and 0.93; SpE versus C(p) 0.92, 0.95, and 0.97; and SpE versus C(eff) 0.88, 0.94, and 0.95; 2) during maintenance: SpE versus C(eff) 0.86, 0.75, and 0.81. The pharmacodynamic analysis determined an association between SpE and C(p) that followed the E(max) model closely. There were significant differences in SpE values between age groups at corresponding UMSS sedation levels. Conclusions SpE measures the level of hypnosis and hypnotic drug effect in children during total intravenous anesthesia. There is an age dependency associated with SpE. Anesthesia should not be steered solely on the basis of SpE.

Sign in / Sign up

Export Citation Format

Share Document