Does the Use of Electroencephalographic Bispectral Index or Auditory Evoked Potential Index Monitoring Facilitate Recovery after Desflurane Anesthesia in the Ambulatory Setting?

Background This study investigates the accuracy of a composite index, the A-Line(R) auditory evoked potentials index version 1.6 (AAI1.6; Danmeter A/S, Odense, Denmark), as a measure of cerebral anesthetic drug effect in a model for predicting a calculated effect site concentration of propofol (CePROP). The AAI1.6 algorithm extracts information from the midlatency auditory evoked potentials, the spontaneous electroencephalographic activity, and the detection of burst suppression. The former version of this monitor, the A-Line auditory evoked potential index version 1.5, is only based on fast extracted midlatency auditory evoked potential information. Methods After institutional ethics committee approval (University Hospital, Ghent, Belgium), informed consent was obtained from 13 patients (10 women, 3 men) with an American Society of Anesthesiologists physical status of I, aged 18-65 yr, who were scheduled to undergo ambulatory gynecologic or urologic surgery. The authors evaluated for Bispectral Index, A-Line auditory evoked potential index, version 1.5, AAI1.6 scaled from 0 to 100 and AAI1.6 scaled from 0 to 60, the interpatient stability at baseline, the detection of burst suppression, prediction probability, and correlation with CePROP, during a constant infusion of 1% propofol at 300 ml/h. The authors developed pharmacodynamic models relating the predicted CePROP to each measure of cerebral anesthetic drug effect. Results Bispectral Index had the lowest interindividual baseline variability. No significant difference was found with prediction probability analysis for all measures. Comparisons for correlation were performed for all indices. The AAI1.6 scaled to 60 had a significantly higher correlation with CePROP compared with all other measures. The AAI1.6 scaled to 100 had a significant higher correlation with CePROP compared with the A-Line auditory evoked potential index version 1.5 (P < 0.05) Conclusions The authors found that the application of AAI1.6 has a better correlation with a calculated CePROP compared with a solitary fast extracting midlatency auditory evoked potential measure. Whether this improvement in pharmacodynamic tracing is accompanied by an improved clinical performance should be investigated using clinical endpoints.

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Change in auditory evoked potential index and bispectral index during induction of anesthesia with anesthetic drugs

Journal of Clinical Monitoring and Computing ◽

10.1007/s10877-014-9643-x ◽

2014 ◽

Vol 29 (5) ◽

pp. 621-626 ◽

Cited By ~ 4

Author(s):

Sachiko Matsushita ◽

Shinya Oda ◽

Kei Otaki ◽

Masaki Nakane ◽

Kaneyuki Kawamae

Keyword(s):

Bispectral Index ◽

Evoked Potential ◽

Auditory Evoked Potential ◽

Anesthetic Drugs ◽

Potential Index

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The Effects of Ketamine and Rocuronium on the A-Line® Auditory Evoked Potential Index, Bispectral Index, and Spectral Entropy Monitor during Steady State Propofol and Remifentanil Anesthesia

Anesthesiology ◽

10.1097/00000542-200612000-00012 ◽

2006 ◽

Vol 105 (6) ◽

pp. 1122-1134 ◽

Cited By ~ 17

Author(s):

Hugo E. M. Vereecke ◽

Ann L. Vanluchene ◽

Eric P. Mortier ◽

Karel Everaert ◽

Michel M. R. F. Struys

Keyword(s):

Steady State ◽

Bispectral Index ◽

Evoked Potential ◽

Auditory Evoked Potential ◽

Control Group ◽

Mean Values ◽

State Entropy ◽

Potential Index ◽

Group Response ◽

Response Entropy

Background The authors studied the effects of ketamine and rocuronium on the Bispectral Index, A-Line auditory evoked potential index, state entropy, and response entropy during a calculated steady state anesthesia with propofol and remifentanil. Methods After ethics committee approval, 42 patients were allocated to four groups. Baseline measurements were performed after implementing a calculated steady state anesthesia with propofol and remifentanil. The control group received no additional medication. The ketamine group received a bolus and continuous infusion of ketamine. The rocuronium group received a bolus of rocuronium. The rocuronium-ketamine group received both. All data were stored during 15 min after baseline. After inspection of the raw data, the authors conducted an explorative statistical analysis. Results No significant changes were found in the control group for any of the monitors. Mean values decreased in the rocuronium group for the A-Line auditory evoked potential index, Bispectral Index, and response entropy, but not for state entropy. In the ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not change significantly, but state and response entropy increased. In the rocuronium-ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not decrease as found in the rocuronium group. Response and state entropy increased significantly. Conclusions The response of all monitors after ketamine administration is not affected by simultaneous administration of rocuronium. Interpretation of all studied indices must be done cautiously while taking into account the clinical setting during measurement.

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