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Depth of anesthesia monitoring

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https://www.readbyqxmd.com/read/28183579/determination-of-insertion-depth-of-flexible-laryngeal-mask-airway-in-pediatric-population-a-prospective-observational-study
#1
Ji-Hyun Lee, Hye-Won Oh, In-Kyung Song, Jin-Tae Kim, Chong-Sung Kim, Hee-Soo Kim
STUDY OBJECTIVE: The purpose of this study was to determine the ideal insertion depth of the flexible laryngeal mask airway (FLMA) by elucidating the relationships between insertion depth and patient's age, body weight, height, and other parameters. We also evaluated an insertion technique that uses the change in intracuff pressure for proper positioning of the FLMA in cases where it is difficult to sense resistance during FLMA insertion. DESIGN: This study was a prospective observational study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28177205/monitoring-depth-of-sedation-evaluating-the-agreement-between-the-bispectral-index-qcon-and-the-entropy-module-s-state-entropy-during-flexible-bronchoscopy
#2
Johannes N Müller, Matthias Kreuzer, Paul S García, Gerhard Schneider, Hubert Hautmann
BACKGROUND: We investigated the correlation and agreement of three depth of anesthesia indices, bispectral index (BIS), qCON and state entropy (SE), during propofol sedation, because there is extensive literature that deals with the comparability of these indices during general anesthesia, but not during sedation. METHODS: We recorded electroencephalogram (EEG) and SE trend data, using the Entropy Module from 21 patients who underwent elective bronchoscopy with target-controlled infusion of propofol...
8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28177176/electroencephalographic-discontinuity-during-sevoflurane-anesthesia-in-infants-and-children
#3
Laura Cornelissen, Ann M Bergin, Kimberly Lobo, Carolina Donado, Janet S Soul, Charles B Berde
BACKGROUND: Deep anesthesia in adults may be associated with electroencephalographic (EEG) suppression and higher rates of postoperative complications. Little is known about the impact of anesthetic depth on short- or long-term outcomes in pediatrics. Brain activity monitoring may complement clinical signs of anesthetic depth. This prospective observational study aimed to assess the frequency and degree of profound EEG suppression using multichannel EEG in children during sevoflurane general anesthesia...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28159731/a-prospective-multicenter-single-blind-study-assessing-indices-of-snap-ii-versus-bis-vista-on-surgical-patients-undergoing-general-anesthesia
#4
Sergio D Bergese, Alberto A Uribe, Erika G Puente, R-Jay L Marcus, Randall J Krohn, Steven Docsa, Roy G Soto, Keith A Candiotti
BACKGROUND: Traditionally, anesthesiologists have relied on nonspecific subjective and objective physical signs to assess patients' comfort level and depth of anesthesia. Commercial development of electrical monitors, which use low- and high-frequency electroencephalogram (EEG) signals, have been developed to enhance the assessment of patients' level of consciousness. Multiple studies have shown that monitoring patients' consciousness levels can help in reducing drug consumption, anesthesia-related adverse events, and recovery time...
February 3, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28110742/comparison-of-fft-and-marginal-spectra-of-eeg-using-empirical-mode-decomposition-to-monitor-anesthesia
#5
Shih-Jui Chen, Chia-Ju Peng, Yi-Chun Chen, Yean-Ren Hwang, Ying-Sian Lai, Shou-Zen Fan, Kuo-Kuang Jen
BACKGROUND AND OBJECTIVE: Intraoperative awareness refers that patients can recall aspects of their surgery after being put under general anesthesia. This distressing complication causes affected patients to be conscious and probably feel pain, leading to emotional trauma or other sequelae. Monitoring and administrating the depth of anesthesia is necessary to prevent patients from awareness during a medical operation. In this paper, we analyzed the electroencephalograms (EEGs) of patients to characterize their anesthesia...
December 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28107273/influence-of-depth-of-hypnosis-on-pupillary-reactivity-to-a-standardized-tetanic-stimulus-in-patients-under-propofol-remifentanil-target-controlled-infusion-a-crossover-randomized-pilot-study
#6
Nada Sabourdin, Jean-Baptiste Peretout, Eliane Khalil, Marie-Laurence Guye, Nicolas Louvet, Isabelle Constant
BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related to the amount of administered opioids. The objective of this study was to determine whether at a constant infusion rate of opioids, the pupillary response was influenced by depth of hypnosis assessed by the bispectral index (BIS)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097611/assessing-nitrous-oxide-effect-using-electroencephalographically-based-depth-of-anesthesia-measures-cortical-state-and-cortical-input
#7
Levin Kuhlmann, David T J Liley
Existing electroencephalography (EEG) based depth of anesthesia monitors cannot reliably track sedative or anesthetic states during n-methyl-D-aspartate (NMDA) receptor antagonist based anesthesia with ketamine or nitrous oxide (N2O). Here, a physiologically-motivated depth of anesthesia monitoring algorithm based on autoregressive-moving-average (ARMA) modeling and derivative measures of interest, Cortical State (CS) and Cortical Input (CI), is retrospectively applied in an exploratory manner to the NMDA receptor antagonist N2O, an adjuvant anesthetic gas used in clinical practice...
January 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28064412/journal-of-clinical-monitoring-and-computing-2016-end-of-year-summary-anesthesia
#8
REVIEW
Jan F A Hendrickx, Andre M De Wolf
Clinical monitoring and computing are essential during general anesthesia. As a result it would be impossible to review all the articles published in the Journal of Clinical Monitoring and Computing that are relevant to anesthesia. We therefore will limit this summary to those articles that are uniquely related to anesthesia. The topics include: anesthesia machines; ensuring the airway; anesthetic depth; neuromuscular transmission monitoring; locoregional anesthesia; ultrasound; and pain.
February 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27984262/incidence-of-connected-consciousness-after-tracheal-intubation-a-prospective-international-multicenter-cohort-study-of-the-isolated-forearm-technique
#9
Robert D Sanders, Amy Gaskell, Aeyal Raz, Joel Winders, Ana Stevanovic, Rolf Rossaint, Christina Boncyk, Aline Defresne, Gabriel Tran, Seth Tasbihgou, Sascha Meier, Phillip E Vlisides, Hussein Fardous, Aaron Hess, Rebecca M Bauer, Anthony Absalom, George A Mashour, Vincent Bonhomme, Mark Coburn, Jamie Sleigh
BACKGROUND: The isolated forearm technique allows assessment of consciousness of the external world (connected consciousness) through a verbal command to move the hand (of a tourniquet-isolated arm) during intended general anesthesia. Previous isolated forearm technique data suggest that the incidence of connected consciousness may approach 37% after a noxious stimulus. The authors conducted an international, multicenter, pragmatic study to establish the incidence of isolated forearm technique responsiveness after intubation in routine practice...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27973936/recovery-profile-and-patient-satisfaction-after-ambulatory-anesthesia-for-dental-treatment-a-crossover-comparison-between-propofol-and-sevoflurane
#10
Keita Ohkushi, Ken-Ichi Fukuda, Yoshihiko Koukita, Yuzuru Kaneko, Tatsuya Ichinohe
The purpose of this study was to determine which anesthetic was preferable for ambulatory anesthesia: propofol alone or sevoflurane alone. A crossover study was performed to compare the recovery profile and patient satisfaction after 2 anesthesia methods. Twenty healthy patients with severe anxiety toward dental treatment undergoing 2 sessions of day-case dental treatment received either propofol or sevoflurane anesthesia. The order of these methods was randomized. The depths of anesthesia were kept constant using bispectral index (BIS) monitoring...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27867719/monitoring-cerebral-oxygenation-and-local-field-potential-with-a-variation-of-isoflurane-concentration-in-a-rat-model
#11
Dong-Hyuk Choi, Teo Jeon Shin, Seonghyun Kim, Jayyoung Bae, Dongrae Cho, Jinsil Ham, Ji-Young Park, Hyoung-Ihl Kim, Seongwook Jeong, Boreom Lee, Jae Gwan Kim
We aimed to investigate experimentally how anesthetic levels affect cerebral metabolism measured by near-infrared spectroscopy (NIRS) and to identify a robust marker among NIRS parameters to discriminate various stages of anesthetic depth in rats under isoflurane anesthesia. In order to record the hemodynamic changes and local field potential (LFP) in the brain, fiber-optic cannulae and custom-made microelectrodes were implanted in the frontal cortex of the skull. The NIRS and LFP signals were continuously monitored before, during and after isoflurane anesthesia...
October 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27856360/sensitivity-to-isoflurane-anesthesia-increases-in-autism-spectrum-disorder-shank3-%C3%A2-c-mutant-mouse-model
#12
Changsheng Li, Michele Schaefer, Christy Gray, Ya Yang, Orion Furmanski, Sufang Liu, Paul Worley, C David Mintz, Feng Tao, Roger A Johns
Autism is a heterogeneous developmental disorder characterized by impaired social interaction, impaired communication skills, and restricted and repetitive behavior. The abnormal behaviors of these patients can make their anesthetic and perioperative management difficult. Evidence in the literature suggests that some patients with autism or specific autism spectrum disorders (ASD) exhibit altered responses to pain and to anesthesia or sedation. A genetic mouse model of one particular ASD, Phelan McDermid Syndrome, has been developed that has a Shank3 haplotype truncation (Shank3(+/Δc))...
November 14, 2016: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/27823709/the-utility-of-perioperative-polygraphy-in-the-diagnosis-of-obstructive-sleep-apnea
#13
Ivan Cundrle, Milos Belehrad, Milan Jelinek, Lyle J Olson, Ondrej Ludka, Vladimir Sramek
OBJECTIVE/BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent and often undiagnosed in surgical patients. The aim of this study was to compare polygraphy (PG) performed on sedated patients during surgery to overnight polysomnography (PSG). It was hypothesized that perioperative PG may be used to diagnose OSA. PATIENTS/METHODS: Overnight PSG was performed three days prior to surgery. For surgery, spinal anesthesia and sedation with propofol infusion were used...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27790356/moderate-hypothermia-and-its-effects-in-reducing-the-applied-dose-of-anesthetics-for-patients-with-opium-dependence-in-cardiac-surgery-a-randomized-controlled-trial
#14
Reza Jalaian Taghadomi, Ebrahim Golmakani, Kambiz Alizadeh, Behrooz Mottahedi, Ali Rahdari, Shima Sheybani
BACKGROUND: An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics. OBJECTIVES: This research was primarily intended to determine the potential diminishing effects of moderate hypothermia on anesthetic dosage and recall of anesthesia during the procedure. METHODS: In this double-blind randomized controlled trial, a total of 80 CABG candidates with known addiction to opium were divided into two groups: one normothermic (N) and the other moderately hypothermic (H), both undergoing induction as well as close monitoring from September 2014 to January 2016...
September 2016: Electronic Physician
https://www.readbyqxmd.com/read/27723803/a-comparison-of-multiscale-permutation-entropy-measures-in-on-line-depth-of-anesthesia-monitoring
#15
Cui Su, Zhenhu Liang, Xiaoli Li, Duan Li, Yongwang Li, Mauro Ursino
OBJECTIVE: Multiscale permutation entropy (MSPE) is becoming an interesting tool to explore neurophysiological mechanisms in recent years. In this study, six MSPE measures were proposed for on-line depth of anesthesia (DoA) monitoring to quantify the anesthetic effect on the real-time EEG recordings. The performance of these measures in describing the transient characters of simulated neural populations and clinical anesthesia EEG were evaluated and compared. METHODS: Six MSPE algorithms-derived from Shannon permutation entropy (SPE), Renyi permutation entropy (RPE) and Tsallis permutation entropy (TPE) combined with the decomposition procedures of coarse-graining (CG) method and moving average (MA) analysis-were studied...
2016: PloS One
https://www.readbyqxmd.com/read/27687355/entropy-vs-standard-clinical-monitoring-using-total-intravenous-anesthesia-during-transvaginal-oocyte-retrieval-in-patients-for-in-vitro-fertilization
#16
Saipriya Tewari, Poonam Bhadoria, Sonia Wadhawan, Sudha Prasad, Amit Kohli
STUDY OBJECTIVE: Day care surgery is an important arena for monitors of anesthetic depth where minimizing drug use is essential for rapid turnover. Underdosage, on the other hand, carries the risks of intraoperative awareness and pain. Transvaginal oocyte retrieval (TVOR), often performed under total intravenous anesthesia using propofol and fentanyl in Indian patients, is a procedure of special interest because, in addition to the above concerns, toxic effects of propofol on oocytes have been described...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27640893/monitored-anesthesia-care-for-subcutaneous-cardioverter-defibrillator-implantation-a-single-center-experience
#17
Michael K Essandoh, Andrew J Otey, Mahmoud Abdel-Rasoul, Erica J Stein, Katja R Turner, Nicholas C Joseph, Emile G Daoud
BACKGROUND: To date, general anesthesia has been suggested as the preferred approach for implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD). The purpose of this study was to assess the use of monitored anesthesia care (MAC) for S-ICD implantation. The goals were to assess adequate sedation and analgesia (efficacy endpoints) and major perioperative airway or hemodynamic compromise (safety endpoints). The authors hypothesized that MAC may provide adequate sedation and analgesia and no major perioperative airway or hemodynamic compromise during S-ICD implantation and multiple defibrillation threshold (DFT) testing...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27598398/bispectral-index-monitoring-reduces-the-dosage-of-propofol-and-adverse-events-in-sedation-for-endobronchial-ultrasound
#18
Natividad Quesada, Diego Júdez, Javier Martínez Ubieto, Ana Pascual, Enrique Chacón, Francisco De Pablo, Elisa Mincholé, Salvador Bello
BACKGROUND: Current guidelines recommend monitoring the anesthetic depth of sedation during respiratory endoscopy by using clinical scales despite their subjective nature and the potential change in the level of sedation caused by frequent stimulation. Monitoring by means of the bispectral index (BIS) has shown its utility in reducing the use of drugs and their adverse events in general anesthesia, but evidence in prolonged sedation is insufficient. OBJECTIVE: Our objective was to evaluate BIS in patients undergoing endobronchial ultrasound (EBUS)...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27590919/a-delayed-functional-observer-predictor-with-bounded-error-for-depth-of-hypnosis-monitoring
#19
Neda Eskandari, Z Jane Wang, Guy A Dumont
With the motivation of providing safety for a patient under anesthesia, this paper suggests conditions for evaluating the correctness of an available user interface for systems under shared control based on observability and predictability requirements. Situation awareness is necessary for the user to make correct decisions about the inputs. In this article, we develop a technique to investigate the conditions under which an anesthetists can attain situation awareness about a limited but important aspect of anesthesia, namely depth of hypnosis (DOH)...
September 2, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27585361/advances-in-awareness-monitoring-technologies
#20
Erica J Stein, David B Glick
PURPOSE OF REVIEW: Initial studies suggested that the use of processed electroencephalogram technology could significantly decrease the incidence of unintended intraoperative awareness events during general anesthesia. Subsequent work has cast doubts on these findings. This review will examine the current state of awareness monitoring. RECENT FINDINGS: Recently published randomized controlled trials examining the use of the bispectral index during general anesthesia have not been able to show superiority over other forms of monitoring depth of anesthesia, such as end-tidal anesthetic-agent concentration...
December 2016: Current Opinion in Anaesthesiology
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