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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
#1
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/28106793/hybrid-intelligent-system-to-perform-fault-detection-on-bis-sensor-during-surgeries
#2
José-Luis Casteleiro-Roca, José Luis Calvo-Rolle, Juan Albino Méndez Pérez, Nieves Roqueñí Gutiérrez, Francisco Javier de Cos Juez
This paper presents a new fault detection system in hypnotic sensors used for general anesthesia during surgery. Drug infusion during surgery is based on information received from patient monitoring devices; accordingly, faults in sensor devices can put patient safety at risk. Our research offers a solution to cope with these undesirable scenarios. We focus on the anesthesia process using intravenous propofol as the hypnotic drug and employing a Bispectral Index (BIS(TM)) monitor to estimate the patient's unconsciousness level...
January 18, 2017: Sensors
https://www.readbyqxmd.com/read/28105111/effect-of-rocuronium-on-the-bispectral-index-under-anesthesia-and-tracheal-intubation
#3
Hui Yue, Jinyu Han, Ling Liu, Kaiyuan Wang, Jincheng Li
The aim of the present study was to investigate the effect of various doses of rocuronium on bispectral index (BIS) responses to propofol induction and tracheal intubation, as well as the role of the non-depolarization muscle relaxant rocuronium on the depth of sedation. A total of 72 patients (American Society of Anesthesiologists physical status I-II) were anaesthetized with propofol using a target-controlled infusion, and randomly divided into two sedation level groups (n=36). The patients were divided into 2 groups according to the BIS value: A normal sedation group (group 1), with a stable BIS value at 40-60, and a deep sedation group (group 2), with a BIS value <20 or with burst suppression...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28101342/pharmacodynamic-analysis-of-target-controlled-infusion-of-propofol-in-patients-with-hepatic-insufficiency
#4
Jing-Ru Pan, Jun Cai, Shao-Li Zhou, Qian-Qian Zhu, Fei Huang, Yi-Han Zhang, Xin-Jin Chi, Zi-Qing Hei
The effect of liver dysfunction on target-controlled infusion (TCI) of propofol remains poorly documented. The pharmacodynamic performance of propofol TCI was evaluated in a cohort of Chinese patients with hepatic insufficiency. Fifty-three patients with hepatic insufficiency were enrolled in the current prospective, observational study. Anesthesia was induced with propofol via TCI to a plasma concentration of 3 µg/ml. Following loss of consciousness (LOC), fentanyl and cisatracurium were administered. Pharmacodynamic parameters were recorded during TCI, including time to LOC, bispectral index (BIS), heart rate (HR) and blood pressure...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28099320/closed-loop-delivery-systems-versus-manually-controlled-administration-of-total-iv-anesthesia-a-meta-analysis-of-randomized-clinical-trials
#5
Laura Pasin, Pasquale Nardelli, Margherita Pintaudi, Massimiliano Greco, Massimo Zambon, Luca Cabrini, Alberto Zangrillo
Bispectral Index Scale (BIS)-guided closed-loop delivery of anesthetics has been extensively studied. We performed a meta-analysis of all the randomized clinical trials comparing efficacy and performance between BIS-guided closed-loop delivery and manually controlled administration of total IV anesthesia. Scopus, PubMed, EMBASE, and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocation to treatment and closed-loop delivery systems versus manually controlled administration of total IV anesthesia in any surgical setting...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28094434/the-effect-of-remifentanil-on-propofol-requirements-to-achieve-loss-of-response-to-command-vs-loss-of-response-to-pain
#6
H B Scott, S W Choi, G T C Wong, M G Irwin
When providing total intravenous anaesthesia, careful selection of end-points is required in titrating dose to effect during induction. Although propofol and remifentanil have predominantly different pharmacodynamic effects, they are seen to interact in achieving loss of consciousness and analgesia. To highlight these differences, we performed a double-blind, randomised controlled trial, comparing one group of patients receiving propofol alone (n = 42) with another group receiving remifentanil plus propofol (n = 46) as a target-controlled infusion of remifentanil (Minto; 3 ng...
January 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28079825/the-utility-of-bispectral-index-monitoring-for-prevention-of-rocuronium-induced-withdrawal-movement-in-children-a-randomized-controlled-trial
#7
Byung Gun Lim, Il Ok Lee, Young Sung Kim, Young Ju Won, Heezoo Kim, Myoung Hoon Kong
BACKGROUND: This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children. METHODS: Finally, 135 healthy children (3-12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28078617/changes-in-the-first-postoperative-night-bispectral-index-of-patients-after-thyroidectomy-with-different-types-of-primary-anesthetic-management-a-randomized-controlled-trial
#8
Wen-Fei Tan, Zhi-Lin Wang, Hong Ma, Feng Jin, Huang-Wei Lu
Despite major advances in anesthesia management and developments in anesthetic agents, postoperative sleep disturbances remain dissatisfactory for many patients. We hypothesized that propofol might have a subtle influence on sleep after thyroidectomy compared to sevoflurane. A randomized, single-blinded, controlled trial was conducted at the First Hospital of China Medical University from October 2014 to October 2015. One hundred and twenty-four patients undergoing thyroidectomy were enrolled and received sevoflurane (sevoflurane group) or propofol (propofol group) as anesthesia maintenance...
January 12, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#9
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28068834/design-considerations-of-a-randomized-controlled-trial-of-sedation-level-during-hip-fracture-repair-surgery-a-strategy-to-reduce-the-incidence-of-postoperative-delirium-in-elderly-patients
#10
Tianjing Li, L Susan Wieland, Esther Oh, Karin J Neufeld, Nae-Yuh Wang, Kay Dickersin, Frederick E Sieber
Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28065226/effects-of-two-intranasal-dexmedetomidine-doses-as-premedication-on-sevoflurane-ec50-for-successful-laryngeal-mask-airway-placement-in-children
#11
Jin Xu, Xiao-Ming Deng, Ling-Xin Wei, Dong Yang, Ju-Hui Liu, Juan Zhi, Ya-Nan Li
Objective To observe the effects of two different intranasal dexmedetomidine doses as premedication on the EC50 of sevoflurane for successful laryngeal mask airway placement in children. Methods Children aged 3-6 years, of American Society of Anesthesiologists physical status 1, and scheduled for plastic surgery were enrolled in this study. Children were assigned to receive either spray administration of intranasal dexmedetomidine 1 μg/kg (group D1, n=21) or 2 μg/kg (group D2, n=20) approximately 30 minutes before anesthesia...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#12
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060257/drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci-and-bispectral-analysis-in-obstructive-sleep-apnea
#13
Maximilian Traxdorf, Klaus Tschaikowsky, Claudia Scherl, Judith Bauer, Heinrich Iro, Florian Angerer
The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis...
December 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28050479/dexmedetomidine-in-attenuation-of-haemodynamic-response-and-dose-sparing-effect-on-opioid-and-anaesthetic-agents-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-study
#14
Nandlal Bhagat, Md Yunus, Habib Md Reazaul Karim, Ranendra Hajong, Prithwis Bhattacharyya, Manorama Singh
INTRODUCTION: Perioperative procedures are stressful and lead to haemodynamic instability with potentially devastating consequences. Dexmedetomidine is found to have many of the desired characteristics that are required in perioperative period. AIM: To evaluate the ability of pre and intraoperative dexmedetomidine to attenuate stress induced haemodynamic responses, quantifying the anaesthetic agents sparing as well as its cost-effectiveness in patients undergoing laparoscopic cholecystectomy...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28044337/the-role-and-limitations-of-eeg-based-depth-of-anaesthesia-monitoring-in-theatres-and-intensive-care
#15
REVIEW
Z Hajat, N Ahmad, J Andrzejowski
In this article we will look at some of the principles in processed EEG monitoring as applied to bispectral index (BIS). We outline why BIS should be regarded as a 'memory' monitor which in most circumstances reflects the depth of sedation or anaesthesia in particular patients. Its limitation in paralysed and non-paralysed patients must be understood in order for this monitor to be used safely. Finally, its emerging use in critical care will be explored.
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28041617/-postoperative-surveillance-in-neurosurgical-patients-usefulness-of-neurological-assessment-scores-and-bispectral-index
#16
Silvia Herrero, Enrique Carrero, Ricard Valero, Jose Rios, Neus Fábregas
BACKGROUND AND OBJECTIVES: We examined the additive effect of the Ramsay scale, Canadian Neurological Scale (CNS), Nursing Delirium Screening Scale (Nu-DESC), and Bispectral Index (BIS) to see whether along with the assessment of pupils and Glasgow Coma Scale (GCS) it improved early detection of postoperative neurological complications. METHODS: We designed a prospective observational study of two elective neurosurgery groups of patients: craniotomies (CG) and non-craniotomies (NCG)...
December 29, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28040234/-regulation-of-hypnosis-in-propofol-anesthesia-administration-based-on-non-linear-control-strategy
#17
Muhammad Ilyas, Ali Khaqan, Jamshed Iqbal, Raja Ali Riaz
Continuous adjustment of Propofol in manual delivery of anesthesia for conducting a surgical procedure overburdens the workload of an anesthetist who is working in a multi-tasking scenario. Going beyond manual administration and Target Controlled Infusion, closed-loop control of Propofol infusion has the potential to offer several benefits in terms of handling perturbations and reducing the effect of inter-patient variability. This paper proposes a closed-loop automated drug administration approach to control Depth Of Hypnosis in anesthesia...
December 28, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28033111/improved-spectrum-analysis-in-eeg-for-measure-of-depth-of-anesthesia-based-on-phase-rectified-signal-averaging
#18
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam F Abbod, Jiann-Shing Shieh
The definition of the depth of anesthesia (DOA) is still controversial and its measurement is not completely standardized in modern anesthesia. Power spectral analysis is an important method for feature detection in electroencephalogram (EEG) signals. Several spectral parameters derived from EEG have been proposed for measuring DOA in clinical applications. In the present paper, an improved method based on phase-rectified signal averaging (PRSA) is designed to improve the predictive accuracy of relative alpha and beta power, a frequency band power ratio, total power, median frequency (MF), spectral edge frequency 95 (SEF95), and spectral entropy for assessing anesthetic drug effects...
December 29, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/28027088/feasibility-of-automated-propofol-sedation-for-transcatheter-aortic-valve-implantation-a-pilot-study
#19
Cédrick Zaouter, Thomas M Hemmerling, Stefano Mion, Lionel Leroux, Alain Remy, Alexandre Ouattara
BACKGROUND: Recently, several trials have shown that closed-loop sedation is feasible. No study has used automated sedation in extremely frail patients, such as those scheduled for transcatheter aortic valve implantation (TAVI). We developed and tested a novel automated sedation system for this kind of population and surgery. The system integrates a decision support system that detects respiratory and hemodynamic events via smart alarms, which provide pertinent/related clinical suggestions and treatment options...
December 22, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28027085/bispectral-index-can-reliably-detect-deep-sedation-in-mechanically-ventilated-patients-a-prospective-multicenter-validation-study
#20
Zhu-Heng Wang, Han Chen, Yan-Lin Yang, Zhong-Hua Shi, Qing-Hua Guo, Yu-Wei Li, Li-Ping Sun, Wei Qiao, Guan-Hua Zhou, Rong-Guo Yu, Kai Yin, Xuan He, Ming Xu, Laurent J Brochard, Jian-Xin Zhou
BACKGROUND: Excessively deep sedation is prevalent in mechanically ventilated patients and often considered suboptimal. We hypothesized that the bispectral index (BIS), a quantified electroencephalogram instrument, would accurately detect deep levels of sedation. METHODS: We prospectively enrolled 90 critically ill mechanically ventilated patients who were receiving sedation. The BIS was monitored for 24 hours and compared with the Richmond Agitation Sedation Scale (RASS) evaluated every 4 hours...
December 22, 2016: Anesthesia and Analgesia
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