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Depth of anesthesia monitoring

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https://www.readbyqxmd.com/read/29046769/factors-that-affect-the-onset-of-action-of-non-depolarizing-neuromuscular-blocking-agents
#1
REVIEW
Yong Byum Kim, Tae-Yun Sung, Hong Seuk Yang
Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29033729/use-of-rocuronium-and-sugammadex-under-neuromuscular-transmission-monitoring-in-a-patient-with-multiple-sclerosis
#2
Chryssoula Staikou, Martina Rekatsina
Multiple sclerosis (MS) is a potentially disabling disease characterized by demyelinating lesions in the central nervous system. One of the anesthetic challenges encountered in surgical patients with MS is the management of neuromuscular blockade (NMB) and its reversal. We report a case of a 31-year-old female patient suffering from MS, who underwent gynecological surgery under general anesthesia with sevoflurane, fentanyl, and rocuronium which was successfully reversed with sugammadex. Neuromuscular transmission (NMT) monitoring was used to guide the intraoperative doses of rocuronium and also the reversal of NMB by the use of sugammadex to ensure a safe tracheal extubation...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29027770/bispectral-index-bis-and-non-bis-anesthetic-protocols-on-postoperative-recovery-outcomes-a-systematic-review-and-meta-analysis
#3
Min-Hsien Chiang, Shao-Chun Wu, Shih-Wei Hsu, Jo-Chi Chin
BACKGROUND: The study aimed to compare bispectral index (BIS) and non-BIS anesthetic protocols on postoperative recovery outcomes. METHODS: Medline, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until January 21, 2016. RESULTS: Twenty-six studies were included with a total of 9537 patients. BIS monitoring was significantly associated with shorter time to eye opening (P=0.001), time to extubation (P<0.001), and time to orientation (P=0...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28989831/intraoperative-awareness-and-recall-a-comparative-study-of-dexmedetomidine-and-propofol-in-cardiac-surgery
#4
Tufail Ahmad, Nadeem A Sheikh, Nihida Akhter, Bashir A Dar, Riyaz Ahmad
Background Awareness during general anesthesia is undesired and unanticipated patient wakefulness during surgery or recall of intraoperative events. Incidence of awareness in patients undergoing cardiac surgery is significantly higher than the overall incidence of 1% during general surgery. Awareness during cardiac surgery can be prevented by a number of methods. One such method is the supplemental, intraoperative use of sedative agents. Propofol, a bisubstituted phenol, is an intravenous general anesthetic that has been shown to reduce the incidence of awareness...
August 5, 2017: Curēus
https://www.readbyqxmd.com/read/28976844/a-clinical-study-on-the-effect-of-injection-sites-on-efficacy-of-anesthesia-and-pulpal-blood-flow-in-carious-teeth
#5
Q H Zheng, Q C Hong, L Zhang, L Ye, D M Huang
This randomized clinical trial evaluated the efficiency of maxillary infiltration anesthesia in carious teeth at two different injection sites and their impact on the laser Doppler recordings of pulpal blood flow (PBF) during a caries excavation procedure. The null hypothesis tested was that there are no differences in the efficiency of anesthesia and PBF reduction between maxillary infiltrations at the two injection sites. One hundred twenty patients were divided into three groups according to the degree of carious lesion of their maxillary left central incisors (moderate caries, deep caries, or no caries)...
October 4, 2017: Operative Dentistry
https://www.readbyqxmd.com/read/28938299/nonoperating-room-anesthesia-for-endoscopic-procedures
#6
Stephan Knigge, Klaus Hahnenkamp
PURPOSE OF REVIEW: The purpose of this review is to take a look on some practical aspects of anesthetic care in the endoscopy suite, concerning the general approach, safety, and monitoring issues. RECENT FINDINGS: Concerning propofol popularity for sedation during endoscopic procedures new studies create doubt in the safety of higher doses of propofol used for sedation. Careful titration of propofol, addition of synergistic supplements like ketamine and dexmedetomidine, and monitoring of anesthetic depth may limit the dose of propofol given to the patients...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28899891/effect-of-anesthesia-depth-on-postoperative-clinical-outcome-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#7
Qianyu Cui, Yuming Peng, Xiaoyuan Liu, Bo Jia, Jia Dong, Ruquan Han
INTRODUCTION: Recent studies have shown that deep anaesthesia is associated with poor outcomes. However, no randomised controlled trials have been conducted to test the causality in patients undergoing brain tumour resection. METHODS AND ANALYSIS: DEPTH is a multicenter, randomised, parallel-group, blind trial. The depth of general anaesthesia will be monitored using the bispectral index (BIS). Patients elected for supratentorial tumour resection will be randomly allocated to the deep or the light anaesthesia group in which the target BIS value is 35 or 50, respectively...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28890688/metastability-of-neuronal-dynamics-during-general-anesthesia-time-for-a-change-in-our-assumptions
#8
Andrew E Hudson
There is strong evidence that anesthetics have stereotypical effects on brain state, so that a given anesthetic appears to have a signature in the electroencephalogram (EEG), which may vary with dose. This can be usefully interpreted as the anesthetic determining an attractor in the phase space of the brain. How brain activity shifts between these attractors in time remains understudied, as most studies implicitly assume a one-to-one relationship between drug dose and attractor features by assuming stationarity over the analysis interval and analyzing data segments of several minutes in length...
2017: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/28859124/effect-of-general-anesthesia-on-neonatal-aeeg-a-cohort-study-of-patients-with-non-cardiac-congenital-anomalies
#9
Lisanne J Stolwijk, Lauren C Weeke, Linda S de Vries, Maud Y A van Herwaarden, David C van der Zee, Desiree B M van der Werff, Manon J N L Benders, Mona Toet, Petra M A Lemmers
INTRODUCTION: The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG). METHODS: A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist. aEEG monitoring was started six hours preoperatively until 24 hours after surgery. Analysis of classes of aEEG background patterns, ranging from continuous normal voltage to flat trace in six classes, and quantitative EEG-measures, using spontaneous activity transients (SATs) and interSATintervals (ISI), was performed...
2017: PloS One
https://www.readbyqxmd.com/read/28763434/comparison-of-3-hypertonic-saline-and-20-mannitol-for-reducing-intracranial-pressure-in-patients-undergoing-supratentorial-brain-tumor-surgery-a-randomized-double-blind-clinical-trial
#10
Achmet Ali, Aylin Tetik, Pulat A Sabanci, Demet Altun, Nukhet Sivrikoz, Taner Abdullah, Aydin Aydoseli, Altay Sencer, Ibrahim O Akinci
BACKGROUND: In the present study, we hypothesized that 3% hypertonic saline (HS) is more effective than 20% mannitol to reduce intracranial pressure (ICP) and to modify brain bulk in patients undergoing an elective supratentorial craniotomy. MATERIALS AND METHODS: After institutional review board approval, patients scheduled to undergo supratentorial craniotomy were enrolled into this prospective, randomized, double-blind study. The patients were monitored for routine hemodynamic parameters, depth of anesthesia, and ICP...
July 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28749272/ketamine-medetomidine-and-ketamine-medetomidine-midazolam-anesthesia-in-captive-cheetahs-acinonyx-jubatus-comparison-of-blood-pressure-and-kidney-blood-flow
#11
Julia Stagegaard, Arne Hørlyck, Helle B Hydeskov, Mads F Bertelsen
Six clinically healthy captive cheetahs ( Acinonyx jubatus ) were anesthetized twice using two different drug combinations to investigate if blood pressure and kidney blood flow are affected by medetomidine dosage. Protocol KM (2.0 mg/kg ketamine and 0.05 mg/kg medetomidine) was compared with protocol KMM (2.0 mg/kg ketamine, 0.02 mg/kg medetomidine, and 0.1 mg/kg midazolam). Heart rate (HR), respiratory rate (RR), body temperature, end-tidal carbon dioxide pressure (ETCO2), and anesthetic depth were monitored every 10 min...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28738007/comparison-of-intraosseous-pentobarbital-administration-and-thoracic-compression-for-euthanasia-of-anesthetized-sparrows-passer-domesticus-and-starlings-sturnus-vulgaris
#12
Joanne R Paul-Murphy, Andrew Engilis, Peter J Pascoe, D Colette Williams, Kate A Gustavsen, Tracy L Drazenovich, M Kevin Keel, Tamsen M Polley, Irene E Engilis
OBJECTIVE To compare intraosseous pentobarbital treatment (IPT) and thoracic compression (TC) on time to circulatory arrest and an isoelectric electroencephalogram (EEG) in anesthetized passerine birds. ANIMALS 30 wild-caught adult birds (17 house sparrows [Passer domesticus] and 13 European starlings [Sturnus vulgaris]). PROCEDURES Birds were assigned to receive IPT or TC (n = 6/species/group). Birds were anesthetized, and carotid arterial pulses were monitored by Doppler methodology. Five subdermal braided-wire electrodes were used for EEG...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28719431/bispectral-index-measurements-are-not-degraded-during-aeromedical-evacuations
#13
Nicolas Donat, Audrey Cirodde, Clément Hoffmann, Jean-Vivien Schaal, Yannick Masson, Antoine Nau, Paul Vincent Martin, Samuel Madec, Thomas Leclerc
For a decade, depth of anesthesia monitoring has become a reality in the operating room. It provides valuable help for managing anesthesia, especially for unstable patients. This might be particularly relevant during aeromedical evacuation. In this study, we aimed to assess the validity of the bispectral index (BIS) during long-range patient transportation aboard fixed-wing aircraft. BIS was recorded in 30 patients, 25 under anesthesia and 5 awake, during aeromedical evacuations performed by the French Air Force...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28670685/diversity-of-functional-connectivity-patterns-is-reduced-in-propofol-induced-unconsciousness
#14
Heonsoo Lee, Gyu-Jeong Noh, Pangyu Joo, Byung-Moon Choi, Brian Henry Silverstein, Minkyung Kim, Jisung Wang, Woo-Sung Jung, Seunghwan Kim
INTRODUCTION: Recent evidence suggests that the conscious brain is characterized by a diverse repertoire of functional connectivity patterns while the anesthetized brain shows stereotyped activity. However, classical time-averaged methods of connectivity dismiss dynamic and temporal characteristics of functional configurations. Here we demonstrate a new approach which characterizes time-varying patterns of functional connectivity at the subsecond time scale. METHODS: We introduce phase-lag entropy (PLE), a measure of the diversity of temporal patterns in the phase relationships between two signals...
July 3, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28622355/anesthetic-action-on-the-transmission-delay-between-cortex-and-thalamus-explains-the-beta-buzz-observed-under-propofol-anesthesia
#15
Meysam Hashemi, Axel Hutt, Darren Hight, Jamie Sleigh
In recent years, more and more surgeries under general anesthesia have been performed with the assistance of electroencephalogram (EEG) monitors. An increase in anesthetic concentration leads to characteristic changes in the power spectra of the EEG. Although tracking the anesthetic-induced changes in EEG rhythms can be employed to estimate the depth of anesthesia, their precise underlying mechanisms are still unknown. A prominent feature in the EEG of some patients is the emergence of a strong power peak in the β-frequency band, which moves to the α-frequency band while increasing the anesthetic concentration...
2017: PloS One
https://www.readbyqxmd.com/read/28593751/depth-of-anesthesia-monitors-in-sedation-running-together-or-learning-from-their-distances
#16
Stefano Skurzak, Chiara Stratta
No abstract text is available yet for this article.
June 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28574372/monitoring-the-depth-of-anesthesia-using-a-new-adaptive-neuro-fuzzy-system
#17
Ahmad Shalbaf, Mohsen Saffar, Jamie W Sleigh, Reza Shalbaf
Accurate and noninvasive monitoring of the depth of anesthesia (DoA) is highly desirable. Since the anesthetic drugs act mainly on the central nervous system, the analysis of brain activity using electroencephalogram (EEG) is very useful. This paper proposes a novel automated method for assessing the DoA using EEG. Firstly, 11 features including spectral, fractal and entropy are extracted from EEG signal and then, by applying an algorithm according to exhaustive search of all subsets of features, a combination of the best features (Beta-index, sample entropy, shannon permutation entropy and detrended fluctuation analysis) is selected...
May 29, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28553135/impact-of-different-analgesic-depths-and-abdominal-trauma-of-different-severities-on-stress-and-recovery-of-rats-undergoing-total-intravenous-anesthesia
#18
Hai-Ming Huang, Jun Cao, Lin-Mei Zhu, Yu-Qing Chen, Fu-Ding Lu, Hong-Wei Cai
A number of animal models have been developed to examine the pathophysiological consequences of surgical procedures, but anesthetic methods, monitoring, and management measures in these models are very different from those used in humans. This study was designed to create a rat model of abdominal surgery using anesthetic methods and perioperative treatment similar to those used in the clinic and to investigate the effects of different injury severities and depths of anesthesia and analgesia on surgical stress and postoperative recovery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28497615/quantification-of-rat-supraglottic-laryngeal-sensation-threshold
#19
Derrick C Gale, Neel K Bhatt, Randal C Paniello
OBJECTIVE: Laryngeal adductor response (LAR) to air puff is used as a reliable method in evaluating sensation thresholds (ST) in human laryngeal sensory disorders. This method has been difficult to perform in small subjects such as rodents. The aims of this study were to 1) evaluate ST to air puff under binocular microlaryngoscopy in rats to evaluate laryngeal sensory disorders, 2) determine sensory thresholds at varying target locations, and 3) determine the ideal depth of anesthesia...
August 2017: Laryngoscope
https://www.readbyqxmd.com/read/28391200/quasi-periodicities-detection-using-phase-rectified-signal-averaging-in-eeg-signals-as-a-depth-of-anesthesia-monitor
#20
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam Abbod, Jiann-Shing Shieh
Phase-rectified signal averaging (PRSA) has been known to be a useful method to detect periodicities in non-stationary biological signals. Determination of quasi-periodicities in electroencephalogram (EEG) is a candidate for quantifying the changes of depth of anesthesia (DOA). In this paper, DOA monitoring capacity of periodicities detected using PRSA was quantified by assessing EEG signals collected from 56 patients during surgery. The method is compared to sample entropy (SampEn), detrended fluctuation analysis (DFA) and permutation entropy (PE)...
April 3, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
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