The Bispectral Index and Modified Observer's Assessment of Alertness/Sedation Scale Comparable to Effect Site Concentration of Propofol in Koreans

2000 ◽  
Vol 38 (2) ◽  
pp. 251 ◽  
Author(s):  
Ho Yeong Kil ◽  
Seong Ik Lee ◽  
Seung Joon Lee ◽  
Sung Woo Lee ◽  
Dong Ho Lee
Keyword(s):  
Bispectral Index ◽  
Sedation Scale ◽  
Effect Site ◽  
Effect Site Concentration

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

scholarly journals Comparison between Bispectral Index and Patient State Index as Measures of the Electroencephalographic Effects of Sevoflurane

2008 ◽  
Vol 109 (5) ◽  
pp. 799-805 ◽  
Author(s):  
Martin Soehle ◽  
Richard K. Ellerkmann ◽  
Matthias Grube ◽  
Matthias Kuech ◽  
Stefan Wirz ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Pharmacodynamic Modeling ◽  
Depth Of Anesthesia ◽  
Sevoflurane Anesthesia ◽  
Effect Site ◽  
Effect Site Concentration ◽  
Patient State ◽  
State Index ◽  
Patient State Index ◽  
End Tidal

Background The Bispectral Index (BIS) and the Patient State Index (PSI) quantify depth of anesthesia by analyzing the electroencephalogram. The authors examined the response of BIS and PSI to sevoflurane anesthesia. Methods In 22 patients, sevoflurane anesthesia was induced by inhalation with a tight-fitting facemask and was maintained via a laryngeal mask. Sevoflurane concentrations were increased until burst suppression occurred and subsequently decreased until BIS recovered to values above 60. This procedure was repeated twice until patients underwent intubation for subsequent surgery. End-tidal sevoflurane concentrations, BIS, and PSI were recorded simultaneously. The performance of PSI and BIS to predict the estimated sevoflurane effect site concentration, as derived from simultaneous pharmacokinetic and pharmacodynamic modeling, was compared by determination coefficients (rho(2)) and prediction probabilities (P(K)). Results A significant (P < 0.001) correlation between BIS and PSI was found (r(2) = 0.75), and a close sigmoid relation between sevoflurane effect site concentration and both BIS (rho(2) = 0.84 +/- 0.09) and PSI (rho(2) = 0.85 +/- 0.15) was observed. The maximum sevoflurane electroencephalographic effect resulted in PSI values (1.3 +/- 4.3) that were significantly (P = 0.019) lower than BIS values (7.9 +/- 12.1), and the effect site efflux constant k(e0) was significantly smaller (P = 0.001) for PSI (0.13 +/- 0.08 min(-1)) than for BIS (0.24 +/- 0.15 min(-1)). The probability of BIS (P(K) = 0.80 +/- 0.11) to predict sevoflurane effect site concentration did not differ (P = 0.76) from that of PSI (P(K) = 0.79 +/- 0.09). Conclusions The BIS reacted faster to changes in sevoflurane concentrations, whereas the PSI made better use of the predefined index range. However, despite major differences in their algorithms and minor differences in their dose-response relations, both PSI and BIS predicted depth of sevoflurane anesthesia equally well.

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

scholarly journals The relationship between the effect-site concentration of propofol and sedation scale in children: a pharmacodynamic modeling study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Young-Eun Jang ◽  
Sang-Hwan Ji ◽  
Ji-Hyun Lee ◽  
Eun-Hee Kim ◽  
Jin-Tae Kim ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Pharmacodynamic Modeling ◽  
Sedation Scale ◽  
Mixed Effect ◽  
Link Type ◽  
Effect Site ◽  
Nonlinear Mixed Effect ◽  
Effect Site Concentration ◽  
The University ◽  
The Relationship

Abstract Background Continuous infusion of propofol has been used to achieve sedation in children. However, the relationship between the effect-site concentration (Ce) of propofol and sedation scale has not been previously examined. The objective of this study was to investigate the relationship between the Ce of propofol and the University of Michigan Sedation Scale (UMSS) score in children with population pharmacodynamic modeling. Methods A total of 30 patients (aged 3 to 6 years) who underwent surgery under general anesthesia with propofol and remifentanil lasting more than 1 h were enrolled in this study. Sedation levels were evaluated using the UMSS score every 20 s by a 1 μg/mL stepwise increase in the Ce of propofol during the induction of anesthesia. The pharmacodynamic relationship between the Ce of propofol and UMSS score was analyzed by logistic regression with nonlinear mixed-effect modeling. Results The estimated Ce50 (95% confidence interval) of propofol to yield UMSS scores equal to or greater than n were 1.84 (1.54–2.14), 2.64 (2.20–3.08), 3.98 (3.66–4.30), and 4.78 (4.53–5.03) μg/mL for n = 1, 2, 3, and 4, respectively. The slope steepness for the relationship of the Ce versus sedative response to propofol (95% confidence interval) was 5.76 (4.00–7.52). Conclusions We quantified the pharmacodynamic relationship between the Ce of propofol and UMSS score, and this finding may be helpful to predict the sedation score at the target Ce of propofol in children. Trial registration http://www.clinicaltrials.gov (No.: NCT03195686, Date of registration: 22/06/2017).

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