Closed-Loop Feedback Control of Propofol Anaesthesia by Quantitative Eeg Analysis in Humans

Schwilden, H.; Stoeckel, H.; Schüttler, J.

doi:10.1093/bja/62.3.290

Cited by 215 publications

(83 citation statements)

References 9 publications

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“…Although our closed-loop system appeared less stable than that used in the earlier studies with median frequency as the target of control [2,3], this is a characteristic of the BIS when used with lower doses of opioids. In general, median frequency values in our patients were also higher than those targeted in these studies, though this discrepancy may be partly due to different EEG signal filtering and processing.…”

Section: Discussioncontrasting

confidence: 64%

Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control

et al. 2000

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SummaryWe investigated the performance of a closed-loop system for administration of general anaesthesia, using the bispectral index as a target for control. One hundred patients undergoing gynaecological or general surgery were studied. In 60 patients, anaesthesia was maintained by intravenous infusion of a propofol/alfentanil mixture. In 40, an isoflurane/nitrous oxide based technique was used. For each technique, patients were randomly allocated to receive either closed-loop or manually controlled administration of the relevant agents (propofol/alfentanil or isoflurane), with an intra-operative target bispectral index of 50 in all cases. Closed-loop and manually controlled administration of anaesthesia resulted in similar intra-operative conditions and initial recovery characteristics. During maintenance of anaesthesia, cardiovascular and electro-encephalographic variables did not differ between closedloop and manual control groups and deviation of bispectral index from the target value was similar. Intra-operative concentrations of propofol, alfentanil and isoflurane were within normal clinical ranges. Episodes of light anaesthesia were more common in the closed-loop group for patients receiving propofol/alfentanil anaesthesia and in the manual group for patients receiving isoflurane/ nitrous oxide anaesthesia. Convenience aside, the closed-loop system showed no clinical advantage over conventional, manually adjusted techniques of anaesthetic administration.

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Section: Discussioncontrasting

confidence: 64%

Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control

et al. 2000

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“…20,21 The main aim of this study was to see if these protocols were as good on this Indian population as on the western population. The two groups were very similar to each other demographically, other than the age and weight of the patients.…”

Section: Resultsmentioning

confidence: 99%

An analytical study of standard propofol- sufentanil target controlled infusion protocols for total intravenous anaesthesia requirements in an Indian population using bispectral index monitoring

Gupta

Agrawal

2017

Int J Res Med Sci

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Background: Target controlled infusion (TCI) is an automated and regulated total intravenous anaesthesia delivering device. On the basis of western pharmacokinetic and pharmacodynamic models it delivers a calculated dosage of intravenous anaesthetic drugs to achieve an ideal anaesthetic plane. The depth of anaesthesia is judged by monitors such as bispectral index (BIS) monitors which gives a rough estimate whether the TCI is delivering more or less.Methods: This analytical study was carried out on 100 patients between 20 to 60 years of age in a teaching hospital. Simultaneous BIS monitoring and TCI were set on these patients. If BIS values went below 45 the target concentration was decreased by 0.5μg/ml and if it was more than Injection propofol was supplemented manually and the changes were collected and analyzed.Results: On analyses and comparison of the data with a western study it was found that the duration of surgery was similar in both studies. With the help of “t” test based on normal distribution it was found that group having BIS <45 and 45-60 were similar in both studies, but the group having BIS >60 was more statistically significant in the Indian population.Conclusions: Depth of anaesthesia was assessed with neurological monitor, BIS, at the time of administration of Target controlled infusion (TCI) and data acquired was compared with data from a western study. The two groups had similar anaesthetic depth levels with the same infusion protocols of Target controlled infusion (TCI).

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“…Because propofol has been reported to suppress markedly the AEP [26], BIS [27], SEF [5] and MF [6] in dose-dependent fashion, changes in propofol blood concentration, especially its protein unbinding fraction, should affect the results. In the present study, the mean target propofol blood concentration was managed within a narrow range.…”

Section: Discussionmentioning

confidence: 99%

“…Among them, spectral edge frequency (SEF) [2][3][4][5] and median frequency (MF) [5,6] have been studied as the single numerical parameter. Although temperaturedependent changes of SEF [7][8][9] and MF [9] have been studied, their results were inconsistent and there was no study under anaesthesia with propofol and alfentanil.…”

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confidence: 99%

Effects of cardiopulmonary bypass and hypothermia on electroencephalographic variables

et al. 1997

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SummaryWe studied the effects of hypothermia and cardiopulmonary bypass (CPB) on four depth of anaesthesia monitors; spectral edge frequency (SEF), median frequency (MF), bispectral index (BIS) and auditory evoked potential index (AEPIndex) in 12 patients during uneventful cardiac anaesthesia. Each variable was recorded simultaneously at 10 periods during anaesthesia. All four variables were not affected by the transition to CPB. During hypothermia, values of AEPIndex, MF and SEF were tightly distributed but values of BIS were very variable and overlapped with those before induction of anaesthesia. The variability decreased during rewarming. The values of AEPIndex throughout the anaesthesia never overlapped with those before induction of anaesthesia. The AEPIndex was the most stable and reliable as a depth of anaesthesia monitor among the four variables in cardiac bypass surgery.

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Closed-Loop Feedback Control of Propofol Anaesthesia by Quantitative Eeg Analysis in Humans

Cited by 215 publications

References 9 publications

Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control

Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control

An analytical study of standard propofol- sufentanil target controlled infusion protocols for total intravenous anaesthesia requirements in an Indian population using bispectral index monitoring

Effects of cardiopulmonary bypass and hypothermia on electroencephalographic variables

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