Cerebral state monitor, a new small handheld EEG monitor for determining depth of anaesthesia

Anderson, R. E.; Jakobsson, Jan

doi:10.1017/s0265021505002206

Cited by 35 publications

(24 citation statements)

References 23 publications

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“…Utrzymanie BIS w zakresie 40-60 zapewnia głęboki poziom depresji świa- T1 T2 T3 T4 T5 T6 T7 T8 MAP (mm Hg) domości obarczony ryzykiem jej powrotu u znieczulanych chorych [15]. Niniejsze obserwacje w pełni potwierdzają przydatność monitorowania BIS podczas endowaskularnego zaopatrywania tętniaków wewnątrzczaszkowych, zwłasz-cza że stwierdzono istotną korelację między jego wartością i stężeniem środków hipnotycznych [15,16]. Uważa się, że BIS pozwala na prowadzenie kontroli poziomu wyłączenia świadomości [16].…”

Section: Dyskusjaunclassified

Postępowanie anestezjologiczne podczas endowaskularnego leczenia niepękniętych tętniaków wewnątrzczaszkowych

Karwacki¹,

Witkowska²,

Niewiadomski³

et al. 2013

Anaesthesiol Intensive Ther

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Background. Endovascular techniques for treatment of intracranial aneurysms are increasingly commonly applied. In general, the procedures are short, require general anaesthesia and complete immobilisation of patients. The aim of the present study was to assess the usefulness of general anaesthesia with propofol and laryngeal mask airway for endovascular management of intracranial aneurysms based on analysis of haemodynamic stability. Methods. The study encompassed 26 patients undergoing endovascular treatment of intracranial aneurysms. The mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), end-tidal CO 2 (E T CO 2 ) and haemoglobin saturation with oxygen (SpO 2 ) were determined at eight measurement points: T 1 -before anaesthesia induction, T 2 -after induction, T 3 -after LMA insertion, T 4 -during arteriography, T 5 -during "coiling" , T 6 -at completion of propofol infusion, T 7 -before LMA removal, T 8 -after LMA removal. Results. MAP and HR were found significantly reduced between T 2 and T 1 . To maintain BIS within the range of 40-60, the following propofol infusion rates (in mg kg b.w. -1 h -1 ) were required: T 2 -4.5 ± 0.3; T 3 -4.6 ± 0.7; T 4 -4.5 ± 0.8 and T 5 -4.4 ± 0.6. E T CO 2 and SpO 2 were not demonstrated to be changed. The mean duration of anaesthesia and of recovery was 64.3 ± 21.8 and 8.9 ± 4.8 min, respectively. Conclusions. General anaesthesia with propofol and LMA ensures suitable conditions for endovascular treatment of intracranial aneurysms.

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Section: Dyskusjaunclassified

Postępowanie anestezjologiczne podczas endowaskularnego leczenia niepękniętych tętniaków wewnątrzczaszkowych

Karwacki¹,

Witkowska²,

Niewiadomski³

et al. 2013

Anaesthesiol Intensive Ther

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“…The CSI and BIS show similar patterns and numerical values, but large discrepancies between pair-wise readings have All values are given as the mean ± standard deviation (SD) with the range given in parenthesis No significant differences were observed between the bispectral index (BIS) and the cerebral state index (CSI) occasionally been observed [4]. In one study on patients under propofol and remifentanil anesthesia, the CSI indicated that 13% of the patients were awake during parts of the course, despite being clinically sleep; these patients were correctly identified with the BIS [8].…”

Section: Discussionmentioning

confidence: 99%

“…Due to these different calculation algorithms, these indices may be different during anesthesia. Very few studies on the CSI have been published [4][5][6][7][8][9], and none of these have compared the BIS and CSI in patients receiving propofol-fentanyl-nitrous oxide anesthesia. The aim of the study reported here was, therefore, to compare the BIS and CSM (CSI) during propofol-fentanyl-nitrous oxide anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Cerebral state index versus bispectral index during propofol–fentanyl–nitrous oxide anesthesia

Nishiyama¹,

Komatsu

2010

J Anesth

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“…E 2 represents the effect at sevoflurane concentrations from the plateau value to the maximal value while E 1 remains constant. values with both monitors during administration of propofol and inhalational agents [1][2][3][5][6][7] . However, our study is the first clinical investigation of pharmacodynamic modeling using the CSI for adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…The most extensively validated device used for this purpose is the bispectral index (BIS) monitor (Aspect Medical System, Newton, MA, USA). The cerebral state index (CSI), which is obtained by a cerebral state monitor (CSM TM Danmeter, Odense, Denmark), was recently introduced as a measure of the hypnotic component of anesthesia, and its usefulness has been previously evaluated [1][2][3][4][5][6][7] . However, there are no reports regarding the dose-response relationship between sevoflurane concentration and its effect in adults measured with CSI.…”

Section: Introductionmentioning

confidence: 99%

Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

et al. 2011

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Aim:The cerebral state index (CSI) was recently introduced as an electroencephalographic monitor for measuring the depth of anesthesia. We compared the performance of CSI to the bispectral index (BIS) as electroencephalographic measures of sevoflurane effect using two combined sigmoidal E max models. Methods: Twenty adult patients scheduled for laparotomy were studied. After induction of general anesthesia, sevoflurane concentrations were progressively increased and then decreased over 70 min. An analysis of the BIS and CSI with the sevoflurane effect-site concentration was conducted using two combined sigmoidal E max models. Results: The BIS and CSI decreased over the initial concentration range of sevoflurane and then reached a plateau in most patients. A further increase in sevoflurane concentration produced a secondary plateau in the pharmacodynamic response. The CSI was more strongly correlated with effect-site sevoflurane concentration (R 2 =0.95±0.04) than the BIS was (R 2 =0.87±0.07) (P<0.05). The individual E max and C eff50 (effect-site concentration associated with 50% decrease from baseline to plateau) values for the upper and lower plateaus were significantly greater for BIS (12.7±7.3, 1.6±0.4, and 4.2±0.5, respectively) than for CSI (3.4±2.2, 1.2±0.4, and 3.8±0.5, respectively) (P<0.05). The remaining pharmacodynamic parameters for the BIS and CSI were similar. Conclusion: The overall performance of the BIS and CSI during sevoflurane anesthesia was similar despite major differences in their algorithms. However, the CSI was more consistent and more sensitive to changes in sevoflurane concentration, whereas the measured BIS seemed to respond faster. The newly developed combined E max model adequately described the clinical data, including the pharmacodynamic plateau.

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Cerebral state monitor, a new small handheld EEG monitor for determining depth of anaesthesia

Cited by 35 publications

References 23 publications

Postępowanie anestezjologiczne podczas endowaskularnego leczenia niepękniętych tętniaków wewnątrzczaszkowych

Postępowanie anestezjologiczne podczas endowaskularnego leczenia niepękniętych tętniaków wewnątrzczaszkowych

Cerebral state index versus bispectral index during propofol–fentanyl–nitrous oxide anesthesia

Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

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