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Depth of anesthesia monitoring

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https://www.readbyqxmd.com/read/29775401/electroencephalographic-signals-during-anesthesia-recorded-from-surface-and-depth-electrodes
#1
Ville Jäntti, Tuomo Ylinen, Narayan Puthanmadam Subramaniyam, Kotoe Kamata, Arvi Yli-Hankala, Pasi Kauppinen, Eila Sonkajärvi
Purpose - Anesthesiologists have increasingly started to use EEG based indexes to estimate the level and type of unconsciousness. However, the physiology and biophysics are poorly understood in anesthesiological literature. Methods - EEG was recorded from electrodes on the surface of head, including scalp, as well as DBS (deep brain stimulation) electrodes implanted deep in the brain. Mathematical modeling with a realistic head model was performed to create illustrative images of the sensitivity of electrode montages...
May 18, 2018: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#2
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29770643/use-of-the-bispectral-index-to-predict-eye-position-of-children-during-general-anesthesia
#3
Koung Hoon Kook, Seung Ah Chung, Suyoun Park, Dae Hee Kim
PURPOSE: To assess the relationship between eye position and anesthesia depth using the bispectral index (BIS) value, a parameter derived from electroencephalography data. METHODS: We investigated the relationship between BIS value and eye position in 32 children who underwent surgery for epiblepharon under general anesthesia. BIS values were recorded continuously throughout the procedure (from induction to awakening). Eye positions were video-recorded and analyzed after surgery...
May 15, 2018: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/29755997/bispectral-index-in-poisoning-cases-with-multi-drug-ingestion-a-predictable-role-for-early-endotracheal-intubation
#4
Nastaran Eizadi-Mood, Leila Halakoei, Ahmad Yaraghi, Mitra Jabalameli, Rihanak Talakoub, Ali Mohammad Sabzghabaee
Objective: Bispectral index (BIS) is one of the several methods used to monitor the depth of anesthesia. Poisoning with ingestion of different drugs is one of the most common poisonings that have different clinical signs from drowsiness to coma. This study was performed to compare the BIS index number in poisoned patients with multi drugs ingestion with or without the need for endotracheal intubation. Methods: This cross-sectional study was performed on poisoned patients with ingestion of different drugs referring to Clinical Toxicology Department of Noor University Hospital, Isfahan, Iran...
January 2018: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29739183/comparison-between-cerebral-state-index-and-bispectral-index-during-desflurane-anesthesia
#5
Sang-Hyeon Cho, Sung-Su Kim, Dong-Min Hyun, Hyeong-Suk Yoon, JungWoo Han, Jin Sun Kim
Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different EEG signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29701426/is-invasive-pressure-monitoring-more-reliable-than-non-invasive-in-patients-with-cardiovascular-pathology-a-case-report
#6
Andreia Fernandes, Luísa Coimbra, Inês Delgado, José Carvalho, Carla Bentes
INTRODUCTION: Patients undergoing carotid endarterectomy (CEA) require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. Invasive blood pressure (IBP) is the gold standard, however artifacts may lead to erroneous readings. METHODS: We report a case of CEA using IBP monitoring. RESULTS: A 64-year-old man, American Society Anaesthesiology (ASA) physical status 3 (diffuse atheromathosis, dyslipidemia and non-medicated hypertension), was presented for an elective right CEA...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29682080/can-pediatric-bispectral-index-sensor-replace-adult-bispectral-index-sensor-for-depth-of-anesthesia-monitoring
#7
Indu Kapoor, Hemanshu Prabhakar, Charu Mahajan
No abstract text is available yet for this article.
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29643629/intraoperative-neurophysiological-monitoring-team-s-communiqu%C3%A3-with-anesthesia-professionals
#8
Anurag Tewari, Lisa Francis, Ravi N Samy, Dean C Kurth, Joshua Castle, Tiffany Frye, Mohamed Mahmoud
Background and Aims: Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29601275/effects-of-conversational-hypnosis-on-relative-parasympathetic-tone-and-patient-comfort-during-axillary-brachial-plexus-blocks-for-ambulatory-upper-limb-surgery-a-quasiexperimental-pilot-study
#9
Emmanuel Boselli, Hervé Musellec, Franck Bernard, Nicolas Guillou, Pierre Hugot, Caroline Augris-Mathieu, Nathalie Diot-Junique, Lionel Bouvet, Bernard Allaouchiche
This two-center quasiexperimental pilot study was to determine the effect of conversational hypnosis on patient comfort and parasympathetic tone, which may represent a quantitative measure of hypnotic depth, during regional anesthesia. The patients received conversational hypnosis in one center and oral premedication in the other. The patients' subjective comfort (0-10 rating scale) and objective parasympathetic tone, as assessed by the Analgesia/Nociception Index (ANI), were measured before and after regional anesthesia...
April 2018: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/29582946/-effects-of-cannabis-extract-premedication-on-anesthetic-depth
#10
Carlos Ibera, Ben Shalom, Fayez Saifi, Joshua Shruder, Elyad Davidson
BACKGROUND: Cannabis is the most widely used illicit drug in the world, used by approximately 2.7-4.9% of the world's population, and 7.6-10.2% of Israel's adults. During the past few years, legal systems around the world have enacted large scale adoption of the legalization of both medical and recreational cannabis. Anesthetists should therefore be prepared to treat patients who used cannabis and are undergoing elective or emergency operations. However, the interactions between cannabinoids and general anesthetic agents and the possible implications for patient care are not yet fully understood...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29524200/prevalence-of-discordant-elevations-of-state-entropy-and-bispectral-index-in-patients-at-amnestic-sevoflurane-concentrations-a-historical-cohort-study
#11
Richard H Epstein, Joni M Maga, Michael E Mahla, Eric S Schwenk, Marc J Bloom
BACKGROUND: Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. METHODS: Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed...
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29513276/emergence-eeg-pattern-classification-in-sevoflurane-anesthesia
#12
Zhenhu Liang, Cheng Huang, Yongwang Li, Darren F Hight, Logan J Voss, Jamie W Sleigh, Xiaoli Li, Yang Bai
OBJECTIVE: Significant spectral electroencephalogram (EEG) pattern characteristics exist in individual patients during the re-establishment of consciousness after general anesthesia. However, these EEG patterns cannot be quantitatively identified using commercially available depth of anesthesia (DoA) monitors. This study proposes an effective classification method and indices to classify these patterns among patients. APPROACH: Four types of emergence EEG patterns were identified based on the EEG data set from 52 patients undergoing sevoflurane general anesthesia from two hospitals...
April 26, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29497496/recent-advances-in-neuromuscular-block-during-anesthesia
#13
REVIEW
Martijn Boon, Christian Martini, Albert Dahan
Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally improved outcome in the past few decades. Sugammadex, a novel reversal agent with unique encapsulating properties, has changed the landscape of neuromuscular reversal and opened up new opportunities to improve patient care...
2018: F1000Research
https://www.readbyqxmd.com/read/29474212/a-different-perspective-anesthesia-for-extreme-premature-infants-is-there-an-age-limitation-or-how-low-should-we-go
#14
Per-Arne Lönnqvist
PURPOSE OF REVIEW: To put in perspective, the various challenges that faces pediatric anesthesiologists because of the recently lowered limits with regards to the viability of a fetus. Both medical and ethical considerations will be highlighted. RECENT FINDINGS: Issues related to: who should anesthetize these tiny babies; can we provide adequate and legal monitoring during the anesthetic; does these immature babies need hypnosis and amnesia and the moral/ethical implications associated with being involved with care of doubtful long-term outcome are reviewed...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29444638/unusual-elevation-in-entropy-but-not-in-psi-during-general-anesthesia-a-case-report
#15
Young Sung Kim, Dongik Chung, Seok Kyeong Oh, Young Ju Won, Il Ok Lee
BACKGROUND: EEG monitoring is useful for determining an adequate level of anesthesia. However it is sometimes interfered by various reasons. We describe a case in which we successfully confirmed the adequate depth of anesthesia by monitoring the patient state index (PSI), which was computed from the SedLine monitor data in Root (Masimo) during general anesthesia. Our case showed unusual elevations in entropy, but not in PSI. CASE PRESENTATION: A 34-year-old woman was scheduled for emergency surgery for a left tibial open fracture and a right femoral closed fracture, which were sustained during a traffic accident...
February 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29443059/in-vivo-electrophysiological-measurement-of-the-rat-ulnar-nerve-with-axonal-excitability-testing
#16
Brandon M Wild, Renée Morris, Mihai Moldovan, Christian Krarup, Arun V Krishnan, Ria Arnold
Electrophysiology enables the objective assessment of peripheral nerve function in vivo. Traditional nerve conduction measures such as amplitude and latency detect chronic axon loss and demyelination, respectively. Axonal excitability techniques "by threshold tracking" expand upon these measures by providing information regarding the activity of ion channels, pumps and exchangers that relate to acute function and may precede degenerative events. As such, the use of axonal excitability in animal models of neurological disorders may provide a useful in vivo measure to assess novel therapeutic interventions...
February 6, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29433385/intravenous-lidocaine-as-adjuvant-to-general-anesthesia-in-renal-surgery
#17
Mohamed Said Nakhli, Mohamed Kahloul, Taieb Guizani, Chekib Zedini, Ajmi Chaouch, Walid Naija
The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1...
December 2018: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/29390270/anesthetic-management-of-off-pump-simultaneous-coronary-artery-bypass-grafting-and-lobectomy-case-report-and-literature-review
#18
REVIEW
Xian Zhao, Yuhong Li, Hai-Ying Kong, Lin Zhang, Xiao-Hong Wen
RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29369096/electroencephalography-and-brain-oxygenation-monitoring-in-the-perioperative-period
#19
Thomas W L Scheeren, Merel H Kuizenga, Holger Maurer, Michel M R F Struys, Matthias Heringlake
Maintaining brain function and integrity is a pivotal part of anesthesiological practice. The present overview aims to describe the current role of the 2 most frequently used monitoring methods for evaluation brain function in the perioperative period, ie, electroencephalography (EEG) and brain oxygenation monitoring. Available evidence suggests that EEG-derived parameters give additional information about depth of anesthesia for optimizing anesthetic titration. The effects on reduction of drug consumption or recovery time are heterogeneous, but most studies show a reduction of recovery times if anesthesia is titrated along processed EEG...
January 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29341401/the-prediction-probabilities-for-emergence-from-sevoflurane-anesthesia-in-children-a-comparison-of-the-perfusion-index-and-the-bispectral-index
#20
Pei-Pei Liu, Chi Wu, Jun-Zheng Wu, Ma-Zhong Zhang, Ji-Jian Zheng, Yang Shen, Pan He, Ying Sun
BACKGROUND: Predicting recovery of consciousness is one of the most essential functions of anesthesia depth monitors in anesthesia practice. Perfusion index and bispectral index are 2 indicators of the anesthesia depth monitoring with different working principles. The progression of the anesthesia emergence stages reflected by those monitors has not been well understood, especially in pediatric patients. The goals of this study were to compare the prediction probabilities of perfusion index and bispectral index in predicting awakening and in differentiating the different levels of arousal during emergence after sevoflurane anesthesia in children undergoing open inguinal hernia repairs...
March 2018: Paediatric Anaesthesia
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