Dexmedetomidine significantly altered normal sleep phenotypes, and the dexmedetomidine-induced state did not compensate for sleep need. Thus, in the Sprague Dawley rat, dexmedetomidine-induced sedation is characterized by behavioral, electrographic, and immunohistochemical phenotypes that are distinctly different from similar measures obtained during sleep.
Anaesthesia offers an important tool for the scientific study of consciousness. Recent works will be discussed with an aim towards answering basic questions regarding the nature of consciousness and how it is removed by anaesthesia. What brain areas and systems must be turned off to remove consciousness? What brain regions or key processes must be turned back on to restore consciousness? How will a better understanding of the neurobiology of consciousness allow the clinician to give a better and safer anaesthetic? What new monitoring technology might enhance the safety of anaesthesia delivery and reduce the risks of intraoperative awareness? This lecture will touch upon these key topics in order to provide the background needed for understanding future developments in anaesthesia research.Theoretical considerations in monitoring depth of anaesthesia M. Avidan* and E. Whitlock Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA It is surprising that anaesthesiologists routinely monitor the cardiorespiratory effects of anaesthetic agents, but do not consistently attempt to monitor the brain, which is the target organ of general anaesthesia. One possible explanation might be that there are controversies surrounding the efficacy, effectiveness, and cost-effectiveness of currently available brain monitors, most of which are based on processed EEG indices. Another possible reason is that practitioners have generally not received formal training in EEG interpretation and might therefore be reluctant to incorporate the EEG into their practice. However, recent research has shown that with appropriate structured training, anaesthesiologists can learn to recognize features of anaesthesia from a single EEG channel, and can frequently glean useful information from the EEG trace. One of the chief goals of brain monitoring is to track anaesthetic depth and to use the brain monitor to guide the appropriate titration of anaesthetic agents. Hypothetically, depth of anesthesia (DOA) monitors would allow practitioners to decrease the amount of administered anaesthesia without incurring an increased risk of unintended intraoperative awareness.An ideal DOA monitor would need to have certain key attributes, including: (i) As state transitions occur rapidly (e.g. arousal from unresponsive to awake), the index would have near perfect discrimination between consciousness and unconsciousness; or between wakefulness and unresponsiveness, which are clinically relevant surrogates. (ii) A high correlation coefficient would reliably be observed (i.e. in all patients) between the DOA index and the anaesthetic concentration in the brain. If the index were to display significant variability at various anaesthetic concentrations in individual patients, this would curtail its utility. (iii) The DOA index would be sufficiently sensitive (the slope of the concentration response curve would be sufficiently steep) in individual patients to allow reasonably accurate estimation of relative anaesthetic concentration b...
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