CLINICAL USEFULNESS OF BISPECTRAL INDEX FOR TITRATING PROPOFOL TARGET EFFECT-SITE CONCENTRATION.

1997 ◽  
Vol 14 (Supplement 15) ◽  
pp. 60
Author(s):  
M. Struys ◽  
L. Versichelen ◽  
E. Mortier ◽  
G. Rolly
Keyword(s):  
Bispectral Index ◽  
Clinical Usefulness ◽  
Effect Site ◽  
Effect Site Concentration ◽  
Target Effect

scholarly journals Clinical usefulness of the bispectral index for titrating propofol target effect‐site concentration

Anaesthesia ◽  
1998 ◽  
Vol 53 (1) ◽  
pp. 4-12 ◽  
Author(s):  
M. Struys ◽  
L. Versichelen ◽  
G. Byttebier ◽  
E. Mortier ◽  
A. Moerman ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Clinical Usefulness ◽  
Effect Site ◽  
Effect Site Concentration ◽  
Target Effect

Performance of the ARX-derived Auditory Evoked Potential Index as an Indicator of Anesthetic Depth

2002 ◽  
Vol 96 (4) ◽  
pp. 803-816 ◽  
Author(s):  
Michel M. R. F. Struys ◽  
Erik Weber Jensen ◽  
Warren Smith ◽  
N. Ty Smith ◽  
Ira Rampil ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Evoked Potential ◽  
Auditory Evoked Potential ◽  
Noxious Stimulus ◽  
Gynecologic Surgery ◽  
Effect Compartment ◽  
Loss Of Consciousness ◽  
Anesthetic Depth ◽  
Effect Site ◽  
Effect Site Concentration

Background Autoregressive modeling with exogenous input of middle-latency auditory evoked potential (A-Line autoregressive index [AAI]) has been proposed for monitoring anesthetic depth. The aim of the current study was to compare the accuracy of this new index with the Bispectral Index (BIS), predicted effect-site concentration of propofol, and hemodynamic measures. Methods Twenty female patients scheduled for ambulatory gynecologic surgery received effect compartment controlled infusion of propofol. Target effect-site concentration was started at 1.5 microg/ml and increased every 4 min by 0.5 microg/ml. At every step, sedation level was compared with monitoring values using different clinical scoring systems and reaction to noxious stimulus. Results Bispectral Index, AAI, and predicted propofol effect-site concentration were accurate indicators for the level of sedation and loss of consciousness. Hemodynamic variables were poor indicators of the hypnotic-anesthetic status of the patient. BIS correlated best with propofol effect-site concentration, followed by AAI. Hemodynamic measurements did not correlate well. No indicators predicted reaction to noxious stimulus. Poststimulus, BIS and AAI showed an increase as a result of arousal. This reaction occurred more rapidly with the AAI than with BIS. Conclusion Bispectral Index, AAI, and predicted propofol effect-site concentration revealed information on the level of sedation and loss of consciousness but did not predict response to noxious stimulus.

scholarly journals Changes of Hemodynamics and Bispectral Index by Tracheal Intubation according to Effect-site Concentration of Remifentanil during Propofol Anesthesia

2007 ◽  
Vol 53 (5) ◽  
pp. 565 ◽  
Author(s):  
Hong Sik Lee ◽  
Jang-Ho Song ◽  
Helen Ki Shinn ◽  
Jeong Uk Han ◽  
Jong-Kwon Jung ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Bispectral Index ◽  
Effect Site ◽  
Effect Site Concentration

Automated Responsiveness Test (ART) Predicts Loss of Consciousness and Adverse Physiologic Responses during Propofol Conscious Sedation

2001 ◽  
Vol 94 (4) ◽  
pp. 585-592 ◽  
Author(s):  
Anthony G. Doufas ◽  
Maryam Bakhshandeh ◽  
Andrew R. Bjorksten ◽  
Robert Greif ◽  
Daniel I. Sessler
Keyword(s):  
Nitrous Oxide ◽  
Conscious Sedation ◽  
Predictive Accuracy ◽  
Control Period ◽  
Loss Of Consciousness ◽  
Effect Site ◽  
Effect Site Concentration ◽  
Target Effect ◽  
Physiologic Responses ◽  
Initial Target

Background The authors evaluated a device designed to provide conscious sedation with propofol (propofol-air), or propofol combined with 50% nitrous oxide (N2O; propofol-N2O). An element of this device is the automated responsiveness test (ART), a method for confirming that patients remain conscious. The authors tested the hypotheses that the ART predicts loss of consciousness and that failure to respond to the ART precedes sedation-induced respiratory or hemodynamic toxicity. Methods The protocol consisted of sequential 15-min cycles in 20 volunteers. After a 15-min control period, propofol was infused to an initial target effect-site concentration of 0.0 microg/ml with N2O or 1.5 microg/ml with air. Subsequently, the propofol target effect-site concentration was increased by a designated increment (0.25 and 0.5 microg/ml) and the process repeated. This sequence was continued until loss of consciousness, as defined by an Observer's Assessment of Alertness/Sedation (OAA/S) score of 10/20 or less, or until an adverse physiologic event was detected. Results The OAA/S score at which only 50% of the volunteers were able to respond to the ART (P50) during propofol-N2O was 11.1 of 20 (95% confidence interval [CI]: 10.6-11.8); the analogous P50 was 11.8 of 20 (95% CI: 11.4-12.3) with propofol-air. Failure to respond to the ART occurred at a plasma propofol concentration of 0.7 +/- 0.6 microg/ml with propofol-N2O and 1.6 +/- 0.6 microg/ml with propofol-air, whereas loss of consciousness occurred at 1.2 +/- 0.8 microg/ml and 1.9 +/- 0.7 microg/ml, respectively. There were no false-normal ART responses. Conclusion The ART can guide individual titration of propofol because failure to respond to responsiveness testing precedes loss of consciousness and is not susceptible to false-normal responses. The use of N2O with propofol for conscious sedation decreases the predictive accuracy of the ART.

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