Bispectral index and the clinically evaluated anaesthetic depth in dogs

2011 ◽  
Vol 38 (6) ◽  
pp. 536-543 ◽  
Author(s):  
Elise H Bleijenberg ◽  
Hugo van Oostrom ◽  
Louise C Akkerdaas ◽  
Arie Doornenbal ◽  
Ludo J Hellebrekers
Keyword(s):  
Bispectral Index ◽  
Anaesthetic Depth

scholarly journals Closed-Loop Anaesthesia Delivery System (CLADSTM) using Bispectral Index: A Performance Assessment Study

2007 ◽  
Vol 35 (3) ◽  
pp. 357-362 ◽  
Author(s):  
G. D. Puri ◽  
B. Kumar ◽  
J. Aveek
Keyword(s):  
Delivery System ◽  
Bispectral Index ◽  
Closed Loop ◽  
Anaesthetic Agent ◽  
Elective Surgery ◽  
Maintenance Phase ◽  
Postoperative Recovery ◽  
Manual Control ◽  
Anaesthetic Depth ◽  
Anaesthesia Delivery

The development of electroencephalographic indices of anaesthetic depth has in turn generated interest in automated anaesthesia delivery systems using these as the input variable. In this paper, one patented closed loop anaesthesia delivery system (CLADS) (502/DEL/2003) is compared to manual control of propofol delivery titrated to the bispectral index (BIS™). Forty ASA I-II patients undergoing elective surgery under general anaesthesia were enrolled in the study. The study participants were randomised using computer generated random numbers to two equal groups. One group received propofol titrated by the CLADS while in the other group (control), anaesthetic delivery was manually titrated to BIS™. Closed loop anaesthetic delivery using our patented system led to lower induction doses of propofol (P<0.05) and less overshoot of the target BIS (P<0.05). The closed loop system maintained BIS to within ±10 of target for a significantly longer time during the maintenance phase of anaesthesia (P <0.01). Smaller amounts of anaesthetic agent were required (P <0.01) and there was faster postoperative recovery (P <0.05). Manual delivery of propofol required the infusion rate to be changed a median of 30 times (IQR 12-45), which required considerable time and attention by the anaesthetist. In conclusion, automated delivery of propofol adjusted to the bispectral index using our CLADS was both effective and efficient as compared to manual control.

scholarly journals Bispectral Index as a Predictor of Sedation Depth during Isoflurane or Midazolam Sedation in ICU Patients

2007 ◽  
Vol 35 (3) ◽  
pp. 348-356 ◽  
Author(s):  
P. V. Sackey ◽  
P. J. Radell ◽  
F. Granath ◽  
C. R. Martling
Keyword(s):  
Clinical Evaluation ◽  
Bispectral Index ◽  
Icu Patients ◽  
Isoflurane Concentration ◽  
Anaesthetic Agents ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Minute Interval ◽  
Anaesthetic Depth ◽  
End Tidal

Bispectral index (BIS) is used for monitoring anaesthetic depth with inhaled anaesthetic agents in the operating room but has not been evaluated as a monitor of sedation depth in the intensive care unit (ICU) setting with these agents. If BIS could predict sedation depth in ICU patients, patient disturbances could be reduced and oversedation avoided. Twenty ventilator-dependent ICU patients aged 27 to 80 years were randomised to sedation with isoflurane via the AnaConDa® or intravenous midazolam. BIS (A-2000 XP, version 3.12), electromyogram activity (EMG) and Signal Quality Index were measured continuously. Hourly clinical evaluation of sedation depth according to Bloomsbury Sedation Score (Bloomsbury) was performed. The median BIS value during a 10-minute interval prior to the clinical evaluation at the bedside was compared with Bloomsbury. Nurses performing the clinical sedation scoring were blinded to the BIS values. End-tidal isoflurane concentration was measured and compared with Bloomsbury. Correlation was poor between BIS and Bloomsbury in both groups (Spearman's rho 0.012 in the isoflurane group and -0.057 in the midazolam group). Strong correlation was found between BIS and EMG (Spearman's rho 0.74). Significant correlation was found between end-tidal isoflurane concentration and Bloomsbury (Spearman's rho 0.47). In conclusion, BIS XP does not reliably predict sedation depth as measured by clinical evaluation in non-paralysed ICU patients sedated with isoflurane or midazolam. EMG contributes significantly to BIS values in isoflurane or midazolam sedated, non-paralysed ICU patients. End-tidal isoflurane concentration appeared to be a better indicator of clinical sedation depth than BIS.

scholarly journals An analytical study of standard propofol- sufentanil target controlled infusion protocols for total intravenous anaesthesia requirements in an Indian population using bispectral index monitoring

2017 ◽  
Vol 5 (4) ◽  
pp. 1528
Author(s):  
Maruti Gupta ◽  
Nitesh Agrawal
Keyword(s):  
Bispectral Index ◽  
Analytical Study ◽  
Total Intravenous Anaesthesia ◽  
Depth Of Anaesthesia ◽  
Intravenous Anaesthesia ◽  
Target Controlled Infusion ◽  
Duration Of Surgery ◽  
Anaesthetic Depth ◽  
Intravenous Anaesthetic ◽  
Time Of Administration

Background: Target controlled infusion (TCI) is an automated and regulated total intravenous anaesthesia delivering device. On the basis of western pharmacokinetic and pharmacodynamic models it delivers a calculated dosage of intravenous anaesthetic drugs to achieve an ideal anaesthetic plane. The depth of anaesthesia is judged by monitors such as bispectral index (BIS) monitors which gives a rough estimate whether the TCI is delivering more or less.Methods: This analytical study was carried out on 100 patients between 20 to 60 years of age in a teaching hospital. Simultaneous BIS monitoring and TCI were set on these patients. If BIS values went below 45 the target concentration was decreased by 0.5μg/ml and if it was more than Injection propofol was supplemented manually and the changes were collected and analyzed.Results: On analyses and comparison of the data with a western study it was found that the duration of surgery was similar in both studies. With the help of “t” test based on normal distribution it was found that group having BIS <45 and 45-60 were similar in both studies, but the group having BIS >60 was more statistically significant in the Indian population.Conclusions: Depth of anaesthesia was assessed with neurological monitor, BIS, at the time of administration of Target controlled infusion (TCI) and data acquired was compared with data from a western study. The two groups had similar anaesthetic depth levels with the same infusion protocols of Target controlled infusion (TCI).

scholarly journals Effects of isoflurane and sevoflurane alone and in combination with butorphanol or medetomidine on the bispectral index in chickens

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Maria Luisa Velasco Gallego ◽  
Olga Martin Jurado ◽  
Jean-Michel Hatt
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Bispectral Index ◽  
Spinal Reflexes ◽  
Non Invasive ◽  
Central Nervous System Depression ◽  
Anaesthetic Depth ◽  
The Difference ◽  
The One ◽  
Anaesthesia Monitoring

Abstract Background The bispectral index (BIS) is an anaesthesia monitoring technique able to assess the level of central nervous system depression in humans and various animal species. In birds, it has been validated in chickens undergoing isoflurane anaesthesia. The aim of this study was to evaluate in an avian species the influence of isoflurane and sevoflurane on BIS, each at different minimum anaesthetic concentrations (MAC) multiples, alone or combined with butorphanol or medetomidine. Ten chickens (5 males and 5 females) underwent general anaesthesia with isoflurane or sevoflurane alone, and combined with either intramuscular administration of butorphanol (1 mg/kg) or medetomidine (0.1 mg/kg), in a prospective and cross-over study (i.e., 6 treatments per animal). BIS measurements were compared to heart rate (HR), non-invasive blood pressure (NIBP) and to a visual analogue scale (VAS) of anaesthesia depth. Results HR was significantly increased, and both NIBP and VAS were significantly reduced, with higher gas concentrations. NIBP (but not HR or VAS) was additionally affected by the type of gas, being lower at higher concentrations of sevoflurane. Butorphanol had no additional effect, but medetomidine led to differences in HR, NIBP, and in particular a reduction in VAS. With respect to deeper level of hypnosis at higher concentrations and the absence of difference between gases, BIS measurements correlated with all other measures (except with HR, where no significant relationship was found) The difference in BIS before (BISpre) and after stimulation (BISpost) did not remain constant, but increased with increasing MAC multiples, indicating that the BISpost is not suppressed proportionately to the suppression of the BISpre values due to gas concentration. Furthermore, neither butorphanol nor medetomidine affected the BIS. Conclusions The difference of degree of central nervous system depression monitored by BIS compared with neuromuscular reflexes monitored by VAS, indicate that BIS records a level of anaesthetic depth different from the one deducted from VAS monitoring alone. BIS provided complementary information such as that medetomidine suppressed spinal reflexes without deepening the hypnotic state. As a consequence, it is concluded that BIS improves the assessment of the level of hypnosis in chickens, improving anaesthesia monitoring and anaesthesia quality in this species.

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