scholarly journals Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol

2015 ◽  
Vol 14 (3) ◽  
pp. 7597-7604 ◽  
Author(s):  
Z.G. Guo ◽  
X.P. Jia ◽  
X.Y. Wang ◽  
P. Li ◽  
X.J. Su ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Anesthetic Depth ◽  
Severe Burns ◽  
Target Controlled Infusion

scholarly journals The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

2020 ◽  
Author(s):  
Soohyuk Yoon ◽  
Seokha Yoo ◽  
Min Hur ◽  
Sun-Kyung Park ◽  
Hyung-Chul Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Bispectral Index ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Anesthetic Depth ◽  
Intraoperative Hypotension ◽  
Cumulative Duration ◽  
The Relationship ◽  
Cumulative Time

Abstract Background The relationship between intraoperative low bispectral index (BIS) values and poor clinical outcomes has been controversial. Intraoperative hypotension is associated with postoperative complication. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

BISPECTRAL INDEX PREDICTS ANESTHETIC DEPTH BETTER THAN PUPILLARY RESPONSES TO LIGHT AND ANESTHESIOLOGY RESIDENTS AT DIFFERENT LEVELS OF TRAINING

1998 ◽  
Vol 89 (Supplement) ◽  
pp. 927A ◽  
Author(s):  
C Sitzwohl ◽  
F A Seibt ◽  
S Steininger ◽  
C Kinstner ◽  
W Lischka ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Anesthetic Depth ◽  
Pupillary Responses ◽  
Different Levels ◽  
Better Than

A435 Bispectral Index Predicts Anesthetic Depth Better Than Pupillary Responses or Anesthesia Residents

1997 ◽  
Vol 87 (Supplement) ◽  
pp. 435A
Author(s):  
C. Sitzwohl ◽  
H.J. Burger ◽  
S.C. Kettner ◽  
C. Hiebet ◽  
M. Greher ◽  
...  
Keyword(s):  
Bispectral Index ◽  
Anesthetic Depth ◽  
Pupillary Responses ◽  
Better Than ◽  
Anesthesia Residents

Closed-loop Control of Anesthesia Using Bispectral Index

2002 ◽  
Vol 96 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Anthony R. Absalom ◽  
Nicholas Sutcliffe ◽  
Gavin N. Kenny
Keyword(s):  
Bispectral Index ◽  
Closed Loop ◽  
Control Variable ◽  
Adult Patients ◽  
Closed Loop Control ◽  
Loop Control ◽  
Set Point ◽  
Target Controlled Infusion ◽  
Performance Error ◽  
Infusion System

Background The Bispectral Index (BIS) is an electroencephalogram-derived measure of anesthetic depth. A closed-loop anesthesia system was built using BIS as the control variable, a proportional-integral-differential control algorithm, and a propofol target-controlled infusion system as the control actuator. Closed-loop performance was assessed in 10 adult patients. Methods Ten adult patients scheduled to undergo elective hip or knee surgery were enrolled. An epidural cannula was inserted, and 0.5% bupivacaine was used to provide anesthesia to T8 before general anesthesia was induced using the propofol target-controlled infusion system under manual control. After the start of surgery, when anesthesia was clinically adequate, automatic control of anesthesia was commenced using the BIS as the control variable. Adequacy of anesthesia during closed-loop control was assessed clinically and by calculating the median performance error, the median absolute performance error, and the mean offset of the control variable. Results The median performance error and the median absolute performance error were 2.2 and 8.0%, respectively. Mean offset of the BIS from the set point was 0.9. Cardiovascular parameters were stable during closed-loop control. Operating conditions were adequate in all patients but one, who began moving after 45 min of stable anesthesia. No patients reported awareness or recall of intraoperative events. In three patients, there was oscillation of the measured BIS around the set point. Conclusions The system was able to provide clinically adequate anesthesia in 9 of 10 patients. Further studies are required to determine whether control performance can be improved by alterations to the gain factors or by using an effect site-targeted, target-controlled infusion propofol system.

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.

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