The method of automated adjustment and controlled maintenance of surgical stage of anesthesia in modern anesthesia machines

Doklady BGUIR ◽  
2020 ◽  
Vol 18 (8) ◽  
pp. 77-82
Author(s):  
A. A. Satsishur
Keyword(s):  
Theoretical Analysis ◽  
General Anesthesia ◽  
Medical Devices ◽  
Bispectral Index ◽  
Surgical Intervention ◽  
Breathing Circuit ◽  
Volatile Anesthetic ◽  
Anesthesia Machine ◽  
Bispectral Index Monitoring ◽  
Anesthesia Machines

The method of automatical adjustment controlled maintenance of the surgical stage of anesthesia of patient during general anesthesia by means of volatile anesthetic dosage regulation depending on BIS level is described and explained. There was conducted a theoretical analysis of possibilities and perspectives of anesthesia depth’s automatical adjustment during general anesthesia by bispectral index individual monitoring depending on volatile anesthetic dosage and individual patient’s condition along with extent of surgical intervention. The possibilities of currently available medical devices allowing to implement the method into the practice have been analyzed. The technical explanation of interaction between modern volatile anesthetic vaporizer and bispectral index monitoring by feedback from integrated microprocessor, breathing circuit and multiple gas monitor of anesthesia machine and microprocessor of vaporizer has been presented.

The Detection of Cerebral Hypoperfusion with Bispectral Index Monitoring During General Anesthesia

2005 ◽  
Vol 100 (1) ◽  
pp. 158-161 ◽  
Author(s):  
Yasuhiro Morimoto ◽  
Yoko Monden ◽  
Kazunobu Ohtake ◽  
Takefumi Sakabe ◽  
Satoshi Hagihira
Keyword(s):  
General Anesthesia ◽  
Bispectral Index ◽  
Cerebral Hypoperfusion ◽  
Bispectral Index Monitoring

scholarly journals Anesthetic dose correction in hospital pharmacology using bispectral index monitoring technology

2012 ◽  
Vol 65 (5-6) ◽  
pp. 228-232
Author(s):  
Dragana Kastratovic ◽  
Nadezda Radosic ◽  
Branko Milakovic ◽  
Snjezana Tomic ◽  
Vladimir Nesic ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Bispectral Index ◽  
Maxillofacial Surgery ◽  
Individual Characteristics ◽  
Total Consumption ◽  
Bispectral Index Monitoring ◽  
Clinical Center ◽  
Group A ◽  
Waking Up ◽  
Group B

Introduction. Modern hospital pharmacology insists on assessing each patient?s individual characteristics because of their influence on drug pharmacokinetics and pharmacodynamic effect. The study was aimed at evaluating anesthetic doses in patients with benign larynx tumors treated by general endotracheal anesthesia during endoscopic surgery procedures. Material and Methods. The study is a part of a prospective, phase IV, academic study carried out at the Clinical Center of Serbia. The evaluation included 30 patients, who were divided into two groups: Group A - 10 patients, anesthetized with standard recommended anesthetic doses. The insight into the obtained bispectral index values was possible only after completion of the surgery. Group B consisted of 20 patients, anesthetized with anesthetic doses corrected according to bispectral index monitoring values. Results. The average duration of waking up in group A and B was 120.0 ?10.0 sec and B 70.0?9.0 sec, respectively, (p<0.01). When compared with group A the corrected induction anesthetic doses, corrected maintenance doses and anesthetic total consumption were lower in group B by 25% (p<0.01), 15% (p<0.01) and 25% (p<0.01), respectively. Conclusion. It is possible to overdose anesthetic drug during surgery without using bispectral index technology monitoring during general anesthesia in otorhinolaryngology maxillofacial surgery. Bispectral index monitoring should be the clinical standard in general anesthesia.

BIS Monitoring to Prevent Awareness during General Anesthesia

2001 ◽  
Vol 94 (3) ◽  
pp. 520-522 ◽  
Author(s):  
Michael F. O’Connor ◽  
Suanne M. Daves ◽  
Avery Tung ◽  
Richard I. Cook ◽  
Ronald Thisted ◽  
...  
Keyword(s):  
Cost Analysis ◽  
General Anesthesia ◽  
Bispectral Index ◽  
Large Study ◽  
Power Analysis ◽  
The Past ◽  
Bispectral Index Monitoring ◽  
Number Of Patients ◽  
Bispectral Index Monitor ◽  
The Cost

Background Unexpected awareness is a rare but well-described complication of general anesthesia that has received increased scientific and media attention in the past few years. Transformed electroencephalogram monitors, such as the Bispectral Index monitor, have been advocated as tools to prevent unexpected recall. Methods The authors conducted a power analysis to estimate how many patients would be needed in an appropriately powered study to demonstrate the Bispectral Index monitor reduces awareness, as well as a cost analysis to assess the cost of using the monitor for this purpose alone. Results If unexpected recall is rare (1 in 20,000), it will require a large study to demonstrate that the monitor reduces awareness (200,000-800,000 patients), and the cost of using it for this purpose alone would be high ($400,000 per case prevented). If awareness is common (1 in 100), then the number of patients needed in a study to demonstrate that the monitor works becomes tractable (1,000-4,000 patients), and the cost of using the monitor for this purpose alone becomes lower ($2,000 per case prevented). Because there are reported cases of awareness despite Bispectral Index monitoring, the authors are certain that the effectiveness of the monitor is less than 100%. As the performance of the monitor decreases from 100%, the size of the study needed to demonstrate that it works increases, as does the cost of using it to prevent awareness. Conclusion The contention that Bispectral Index monitoring reduces the risk of awareness is unproven, and the cost of using it for this indication is currently unknown.

The Effectiveness of Bispectral Index Monitoring on Carotid Endarterectomy with General Anesthesia

2013 ◽  
Vol 19 (1) ◽  
pp. 31-36
Author(s):  
Funda Gumus ◽  
Kerem Erkalp ◽  
Sitki N. Sinikoglu ◽  
Mehmet S. Sevdi ◽  
Abdulkadir Yektas ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Carotid Endarterectomy ◽  
Bispectral Index ◽  
Bispectral Index Monitoring

scholarly journals Environmental And Economic Impact of Using A Higher Efficiency Ventilator And Vaporizer During Surgery Under General Anesthesia: A Randomized Controlled Prospective Cohort

2021 ◽  
Author(s):  
Ryan Field ◽  
Michael-David Calderon ◽  
Steven Mason Ronilo ◽  
Michael Ma ◽  
Hailey Maxwell ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Gas Flow ◽  
Elective Surgery ◽  
Breathing Circuit ◽  
Volatile Anesthetic ◽  
Environmental Benefits ◽  
Low Flow ◽  
Volatile Agent ◽  
Parametric Testing ◽  
Student’S T

Abstract Background: Compared to traditional breathing circuits, low-flow anesthesia machines utilize a low-volume breathing circuit system by injecting volatile agent into the circuit mainly during inspiration. We aimed to assess whether Maquet Flow-i C20 anesthesia workstation delivers volatile anesthetic more efficiently than a GE Aisys CS2 during elective general surgery. Methods: Eligible candidates enrolled in the study (2014-1248) met the following inclusion criteria: 18 – 65 years old, scheduled for surgery requiring general anesthesia at UC Irvine Health, and expected to receive sevoflurane for the duration of the procedure. Exclusion criteria: < 18 years old, history of COPD, cardiovascular disease, sevoflurane sensitivity, BMI > 30 kg/m2, ASA > 2, pregnant, or surgery scheduled < 120 minutes. We calculated the total amount of sevoflurane delivered and consumption rates during induction/maintenance periods and compared the groups using parametric testing (Student’s t-Test). Results: In total, 103 subjects (Maquet: n=52, GE: n=51) were analyzed. Overall, the Flow-i C-20 group consumed significantly less sevoflurane (95.5 ± 49.3 g) compared to the Aisys2 (118.2 ± 62.4 g) (p = 0.043 for group difference) corresponding to an approximately 20% efficiency improvement in overall agent delivery. When accounting for the fresh gas flow setting, agent concentration and length of induction, the Maquet machines delivered volatile agent at a significantly lower rate compared to the GE devices (7.4 ± 3.2 L/min vs. 9.2 ± 4.1 L/min; p = 0.017). Based on these results, we estimate that the Maquet Flow-i workstations can save an estimated average of $239,440 over the expected 10-year machine lifespan. This 20% decrease in CO2 equivalent emissions corresponds to 201 metric tons less greenhouse gas emissions over a decade compared to the GE Aisys; equivalent to 491,760 miles driven by an average passenger vehicle or 219,881 pounds of coal burned.Conclusions: Overall, our results from this pilot study suggest that the Maquet Flow-i delivers significantly less (~20%) volatile agent during routine elective surgery using a standardized anesthetic protocol compared to a traditional anesthesia system. The results demonstrate a strong opportunity for economic and environmental benefits if implemented across other medical institutions.

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