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By Scott Bentley General Practitioner / GP Anaesthetist in Australia.
Pierre-Yves Lequeux, Fidelie Hecquet, Philippe Bredas
BACKGROUND: Implicit learning of intraoperative auditory stimuli during general anesthesia is very difficult to quantify but may require the presence of noxious stimulation. We hypothesized that an anesthetic regimen with a low dose of opioid would enhance implicit memory, while a regimen with a high dose of opioid would not. METHODS: One hundred-twenty patients were randomized into 3 groups. All patients were anesthetized with a target-controlled infusion of propofol and remifentanil, targeting a Bispectral Index (BIS) value of 50...
November 2014: Anesthesia and Analgesia
Christine Yoo, Elizabeth A Ayello, Bryan Robins, Victor R Salamanca, Marc J Bloom, Patrick Linton, Harold Brem, Daniel K O'Neill
The bispectral (BIS) monitor uses brain electroencephalographic data to measure the depth of sedation and pharmacological response during anaesthetic procedures. In this case, the BIS monitor was used for another purpose, to demonstrate postoperatively to the nursing staff that a patient with history of locked-in syndrome (LIS), who underwent pressure ulcer debridement, had periods of wakefulness and apparent sensation, even with his eyes closed. Furthermore, as patients with LIS can feel pain, despite being unable to move, local block or general anaesthesia should be provided for sharp surgical debridement and other painful procedures...
October 2014: International Wound Journal
K O Pryor, H C Hemmings
No abstract text is available yet for this article.
October 2014: British Journal of Anaesthesia
J J Pandit, J Andrade, D G Bogod, J M Hitchman, W R Jonker, N Lucas, J H Mackay, A F Nimmo, K O'Connor, E P O'Sullivan, R G Paul, J H M G Palmer, F Plaat, J J Radcliffe, M R J Sury, H E Torevell, M Wang, J Hainsworth, T M Cook
We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities...
October 2014: British Journal of Anaesthesia
Michael S Avidan, Eric Jacobsohn, David Glick, Beth A Burnside, Lini Zhang, Alex Villafranca, Leah Karl, Saima Kamal, Brian Torres, Michael O'Connor, Alex S Evers, Stephen Gradwohl, Nan Lin, Ben J Palanca, George A Mashour
BACKGROUND: Unintended intraoperative awareness, which occurs when general anesthesia is not achieved or maintained, affects up to 1% of patients at high risk for this complication. We tested the hypothesis that a protocol incorporating the electroencephalogram-derived bispectral index (BIS) is superior to a protocol incorporating standard monitoring of end-tidal anesthetic-agent concentration (ETAC) for the prevention of awareness. METHODS: We conducted a prospective, randomized, evaluator-blinded trial at three medical centers...
August 18, 2011: New England Journal of Medicine
Michael S Avidan, Lini Zhang, Beth A Burnside, Kevin J Finkel, Adam C Searleman, Jacqueline A Selvidge, Leif Saager, Michelle S Turner, Srikar Rao, Michael Bottros, Charles Hantler, Eric Jacobsohn, Alex S Evers
BACKGROUND: Awareness during anesthesia is a serious complication with potential long-term psychological consequences. Use of the bispectral index (BIS), developed from a processed electroencephalogram, has been reported to decrease the incidence of anesthesia awareness when the BIS value is maintained below 60. In this trial, we sought to determine whether a BIS-based protocol is better than a protocol based on a measurement of end-tidal anesthetic gas (ETAG) for decreasing anesthesia awareness in patients at high risk for this complication...
March 13, 2008: New England Journal of Medicine
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