Bispectral Index Monitoring:Validity and Utility in Pediatric Dentistry

2014 ◽  
Vol 38 (4) ◽  
pp. 366-369
Author(s):  
A Goyal ◽  
N Mittal ◽  
P Mittal ◽  
K Gauba
Keyword(s):  
General Anesthesia ◽  
Present Article ◽  
Bispectral Index ◽  
Index System ◽  
Vital Sign ◽  
Age Groups ◽  
Pediatric Dentistry ◽  
Sedation Level ◽  
Sedative Drugs ◽  
Do So

Reliable and safe provision of sedation and general anesthesia is dependent on continuous vigilance of patient’s sedation depth. Failure to do so may result in unintended oversedation or undersedation. It is a common practice to observe sedation depth by applying subjective sedation scales and in case of general anesthesia, practitioner is dependent on vital sign assessment. The Bispectral Index System (BIS) is a recently introduced objective, quantitative, easy to use, and free from observer bias, and clinically useful tool to assess sedation depth and it precludes the need to stimulate the patient to assess his sedation level. The present article is an attempt to orient the readers towards utility and validity of BIS for sedation and general anesthesia in pediatric dentistry. In this article, we attempt to make the readers understand the principle of BIS, its variation across sedation continuum, its validity across different age groups and for a variety of sedative drugs.

scholarly journals Bispectral Index Monitoring (BIS) as a Guide for Intubation Without Neuromuscular Blockade in Office-Based Pediatric General Anesthesia: A Retrospective Evaluation

2011 ◽  
Vol 58 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Zakaria S Messieha ◽  
Samuel Guirguis ◽  
Sherine Hanna
Keyword(s):  
General Anesthesia ◽  
Neuromuscular Blockade ◽  
Bispectral Index ◽  
Index System ◽  
Muscle Relaxation ◽  
Pediatric Anesthesia ◽  
Vital Signs ◽  
Mean Value ◽  
American Society ◽  
End Tidal

The Bispectral Index System is a useful guide for timing of adequate intubation conditions in office-based pediatric general anesthesia without neuromuscular blockade. As the number of cases in the office-based setting increase, many clinicians opt to intubate patients without neuromuscular blockade to avoid airway complications associated with skeletal muscle relaxation. Conventionally, this technique is conducted using the traditional monitoring criteria of vital signs, end-tidal inhalation agents, as well as anesthesiologist timing and knowledge of the pharmacodynamics of the anesthetic agent to help determine the proper depth of anesthesia for adequate intubating conditions. This study retrospectively assesses the use of the Bispectral Index System (BIS) as a guide for timing of nonparalytic tracheal intubation in pediatric office-based general anesthesia. Anesthetic records for 168 children, American Society of Anesthesiology physical status I and II, and ranging in age from 18 months to 17 years were retrospectively analyzed. Intubation outcomes were based on 6 preset criteria to reflect the adequacy of the technique. The mean BIS value during the time of intubation was 34.7. There were no complications encountered. A BIS mean value of 34.7 provided adequate intubation conditions without muscle relaxation in office-based pediatric anesthesia without complications.

scholarly journals Prevention of Sevoflurane Delirium and Agitation With Propofol

2013 ◽  
Vol 60 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Zakaria Messieha
Keyword(s):  
Young Children ◽  
General Anesthesia ◽  
Bispectral Index ◽  
Index System ◽  
Parental Satisfaction ◽  
Emergence Delirium ◽  
Novel Approach

Abstract Emergence delirium and agitation (EAD) associated with sevoflurane general anesthesia are very commonly observed in young children. Such events pose a risk for injury as well as decreased parental satisfaction, especially in the ambulatory and office-based setting. This article reviews the different approaches described in the literature to reduce EAD. A novel approach using a Bispectral Index System (BIS)-guided anesthesia with propofol washout technique is proposed as a viable and effective approach to prevent EAD.

Trends and Characteristics of Pediatric Dentistry Patients Treated under General Anesthesia

2018 ◽  
Vol 42 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Maxwell N Rudie ◽  
Michael M Milano ◽  
Michael W Roberts ◽  
Kimon Divaris
Keyword(s):  
General Anesthesia ◽  
Pediatric Dentistry ◽  
Continuing Care ◽  
Administrative Claims ◽  
Care Needs ◽  
Special Health Care ◽  
Chapel Hill ◽  
Dental Rehabilitation ◽  
Tests Of Association ◽  
System Information

Purpose: The aims of this study were to describe the demographic characteristics of pediatric dentistry patients undergoing dental rehabilitation under general anesthesia (DRGA) at UNC-Chapel Hill during the last 13 years and identify factors associated with multiple (1 versus 2 or more) DRGA visits during that timeframe. Study design: Administrative claims data were used to identify children and adolescents (age <18 years) who underwent DRGA between 1/1/2002 and 12/31/2014 at the UNC Hospitals system. Information on children's age, sex and all treatment-associated CDT codes were collected. Descriptive statistics and bivariate tests of association were used for data analyses. Results: There were 4,413 DRGAs among 3,973 children (median age=4 years 8 months, males=55%) during the study period. The annual rate of DRGAs increased over time, peaking (n=447) in 2013. Overall, 9% of children had ≥2 visits with repeat rates up to 18%. There was no association between children's sex and receipt of one versus multiple DRGAs; however, craniofacial cases were more likely (p<0.0005) to have multiple DRGAs compared to non-craniofacial ones. Conclusion: DRGAs are on the increase—with the exception of craniofacial and special health care needs patients, multiple DRGAs may be reflective of sub-optimal adherence to preventive and continuing care recommendations.

scholarly journals Consoantes róticas e variação no português de São Tomé

2019 ◽  
pp. 206-224
Author(s):  
Rodrigo Pereira ◽  
Tjerk Hagemeijer ◽  
Maria João Freitas
Keyword(s):  
Urban Population ◽  
Age Groups ◽  
Phonetic Transcription ◽  
Younger Age ◽  
Do So

We investigate the phonetic variants associated with European Portuguese’s rhotic phonemes /ʀ/ e /ɾ/ in Santomean Portuguese, a variety that presently constitutes the L1 of the majority of San Tomeans, and we discuss the linguistic and sociolinguistic variables that underlie the observed variation. In order to do so, we carried out phonetic transcription of excerpts from 9 spontaneous interviews with Santomean informants, who were recorded in San Tome in 2008 and 2012. The data were transcribed with the EXMARaLDA Partitur software, counted manually, and linguistically analysed. The findings were confronted with recent studies on rhotics in this variety. Our data confirm that the neutralization of the distinction between /ʀ/ and /ɾ/ is a tendency stabilizing in the younger age groups of the urban population of São Tomé (cf. Bouchard, 2017). In light of the overall results, we further propose that São Tomean Portuguese lacks a phonological distinction between /ʀ/ and /ɾ/ (cf. Brandão, 2016; Brandão et al., no prelo).

scholarly journals Effects of Bispectral Index-controlled Use of Magnesium on Propofol Consumption and Sedation Level in Patients Undergoing Colonoscopy

2019 ◽  
Author(s):  
Hamit Yoldas ◽  
Isa Yildiz ◽  
Ibrahim Karagoz ◽  
Mustafa Sit ◽  
Muhammed Nur Ogun ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Sedation Level

scholarly journals The Effect of Sevoflurane Anesthesia for Dental Procedure on Neurodevelopment in Children: A Prospective, Equivalence, Controlled Trial

2020 ◽  
Author(s):  
Pinping Zhou ◽  
Chao Zhang ◽  
Guijin Huang ◽  
Yuan Hu ◽  
Wenzhu Ma ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Age Groups ◽  
Outcome Data ◽  
Clinical Trial Registry ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Significant Difference

Abstract Background: Dental procedures under general anesthesia (DGA) was found to improve the oral health-related quality of children's life. However, some parents and pediatricians expressed concern about the neurotoxicity of general anesthesia. The purpose of this trial was to investigate whether DGA in children has an adverse effect on neurodevelopment.Methods: In this prospective, assessor-masked, controlled, equivalence trial, we recruited 340 children younger than 7 years who were undergoing caries treatment between Feb 1, 2019, and Aug 31, 2019, without factors affecting neurodevelopment. They received either sevoflurane-based general anesthesia or awake-local anesthesia. The Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition was used to evaluate the neurodevelopment of children at six months after surgery, and the Full-Scale IQ (FSIQ) was selected as the primary outcome. Predefine the 95% CI of a difference in means within five (1/3 SD) as the equivalence margin.Results: The outcome data were obtained from 129 children in the general anesthesia group and 144 in the local anesthesia group. The median length of general anesthesia was 130 min (IQR 110 – 160). There was equivalence in means of FSIQ score between the general anesthesia group and the local anesthesia group (local minus general anesthesia 0.46, 95% CI -2.35 to 1.61). There was no significant difference in FSIQ scores between different age groups and different anesthesia durations. Only the mother's education could affect the primary outcome.Conclusions: In this trial, prolonged DGA with a sevoflurane-only anesthetic in preschool children, does not adversely affect neurodevelopment at six months after surgery compared with awake-local anesthesia. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800015216. Registered Mar 15 2018, http://www.chictr.org.cn/showproj.aspx?proj=24830.

scholarly journals Oral Health Care Delivery for Children During COVID-19 Pandemic—A Retrospective Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Avia Fux-Noy ◽  
Luna Mattar ◽  
Aviv Shmueli ◽  
Elinor Halperson ◽  
Diana Ram ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Behavior Management ◽  
Deep Sedation ◽  
Care Delivery ◽  
Medical Center ◽  
Pediatric Dentistry ◽  
Control Measures ◽  
Healthy Children ◽  
Efficient Treatment ◽  
Dental Staff

Aim: COVID-19 outbreak and the lockdown period following was a very challenging time for pediatric dentistry. We aimed to find whether the characteristics of dental care provided to children at the Department of Pediatric Dentistry at Hadassah medical center, Jerusalem, Israel, differed between the periods, before COVID-19 outbreak, during the lockdown period and during the period that followed it.Materials and Methods: We retrospectively reviewed computerized records of patients who visited the pediatric dental clinic at three different periods: pre-lockdown period, lockdown period, and post-lockdown period.Results: Nine-hundred and forty-nine children were included in the study; most of them were healthy children between 3 and 6 years old. During lockdown, all scheduled appointments except for treatments under general anesthesia and deep sedation were canceled due to the government's restrictions; the frequency of treatments with non-pharmacological behavior management, general anesthesia or deep sedation was higher than in the previous or subsequent periods and the use of inhaled/conscious sedation was significantly lower. During lockdown most of the children were diagnosed with dentoalveolar abscess (32.3%), compared to 14 and 21% at the previous or subsequent periods, respectively (P < 0.001). Treatments combination during lockdown included more extractions, pulpectomies and pulp extirpation and less permanent restorations (P < 0.001). None of the staff members was infected with COVID-19 at the clinic during these periods. We concluded that dentists should be updated about Covid-19 modes of transmission and the recommended infection control measures in dental settings. Effective management protocols can help the dental staff to continue to provide efficient treatment and prevent Covid-19 contamination.

scholarly journals Comparison of Anesthesia Depth Monitoring using Conventional and Bispectral Index on Incidence and Severity of Nausea and Vomiting after Urological Surgeries

2018 ◽  
Vol 6 (2) ◽  
pp. 25
Author(s):  
Reihan Shenasi ◽  
Hamzeh Hoseinzadeh ◽  
Hasan Mohammadpor-Anvari ◽  
Davod Aghamohammadi ◽  
Reza Sari-Motlagh
Keyword(s):  
General Anesthesia ◽  
Bispectral Index ◽  
Postoperative Nausea ◽  
Operating Time ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Anesthetic Drugs ◽  
Urological Surgery ◽  
Anesthesia Depth

Bispectral index parameter is used to guide the titration of general anesthesia. This monitoring improves recovery times and hospital discharges, as well as minimizes adverse events. The objective of this study is the comparison of anesthesia depth monitoring by conventional and bispectral index on nausea and vomiting after urological surgery. 180 participants who were scheduled for abdominal urological surgery were studied. Patients before induction of anesthesia were randomize into two groups with and without bispectral index monitoring. Incidence and severity of nausea and vomiting were recorded every 30 minutes for 2 hours and every 6 hours to 24 hours after surgery. The incidence of postoperative nausea and vomiting in Bispectral index group is 14.4% and 8.9% and in control group 28.9% and 23.3%, respectively. The risk of nausea and vomiting after surgery was reduced by 14.5% and 14.4%, respectively in patients monitored with bispectral index.INTRODUCTIONNausea is the conscious perception of medulla stimulation that is associated with vomiting center and create vomiting response (1). General anesthesia with the use of inhalants can cause nausea and vomiting after surgery (Postoperative nausea and vomiting, PONV). The incidence of PONV is reported about 20-30 percent (2). It seems that multiple-factor can cause PONV and few items such as anesthetic drugs, kind of surgery and personal risk factors is effective on PONV. These factors make into two categories that includes factors out of control by anesthesiologists and factors can control by anesthesiologists.1. Factors out of control by anesthesiologists: some of these factors are age, gender, past history of PONV and motion sickness, smoking, kind of surgery, operating time and anesthesia time, anxiety of patients and parents. 2. Factors controlled by anesthesiologists: these factors are associated of anesthesia settings, including premedications, kind of anesthesia, anesthesia drugs during surPublishedby Australian

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