Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane

Aho, A. J.; Kamata, Kotoe; Jäntti, V.; Kulkas, Antti; Hagihira, Satoshi; Huhtala, Heini; Yli‐Hankala, Arvi

doi:10.1093/bja/aev206

Cited by 33 publications

(21 citation statements)

References 28 publications

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“…This could be justified by what Keelara et al studied, they compared preemptive IV paracetamol and NSAID to IV paracetamol in lumbar spine surgery as regards morphine consumption. They stated drugs should be administered preemptively before induction so as to provide sufficient time for the onset of action [13].…”

Section: Discussionmentioning

confidence: 99%

Erector spinae plane block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery

Siam

Aliaa

El-Medany

et al. 2020

Egyptian Journal of Anaesthesia

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Background: Perioperative pain management should be planned preoperatively and based on usage of pharmacological and non-pharmacological modalities as a multimodal analgesia (MMA). Regional anaesthesia has superior advantages than opioid-based anaesthesia and is one of the cornerstones of the Enhanced Recovery After Surgery (ERAS) especially in Patients undergoing spine surgery having already troublesome chronic pain and analgesic use. The present study was carried out to compare erector spinae plane block (ESP) with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery. Materials and Methods: This study was done on thirty adult patients of both sexes scheduled for elective lumbar spine surgery under general anaesthesia. They were randomly categorized into two equal groups (fifteen patients each); ESP was used for group I, and MMA was used for group II. Data was collected on anaesthetic requirements based on entropy monitoring and haemodynamic parameters, stress response measurement based on serum cortisol and blood glucose levels, controlled hypotensive anaesthesia; various drugs required and doses given, intraoperative and postoperative analgesia, postanaesthesia care unit data concerning recovery. Results: The group I (ESP) had statistically significant decrease of the response and the response-state entropy difference levels when compared to the group II (MMA) after stimulus and during the 1st time interval. The incidence of hemodynamic changes was significantly higher in the group I (ESP) than group II (MMA). Only the serum cortisol but not the blood glucose levels had statistically significant lower mean values 4 h postoperatively in group I (ESP) compared to group II (MMA). The patients received ESP had statistically significant lower mean expired isoflurane concentration, decreased emergence time, intraoperative fentanyl consumption and total dose of pethidine given up to 8 hrpostoperatively. Conclusions: Erector spinae plane block (ESP) can be considered safe and effective perioperative analgesic modality for lumbar spine simple decompression surgery. It helps in controlled hypotensive anaesthetic technique and decreases inhalational anaesthetics and intraoperative opioid requirements.

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Section: Discussionmentioning

confidence: 99%

Erector spinae plane block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery

Siam

Aliaa

El-Medany

et al. 2020

Egyptian Journal of Anaesthesia

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“…28 A possible explanation for this result in the current study involves a limitation of the processed-EEG itself that has some delay interpretation compared with the raw EEG. [29][30][31][32] So at the point that the investigator recorded the processed-EEG value, the real depth of anesthesia, as indicated by the raw EEG, may have been lighter, which could have affected the study results.…”

Section: Discussionmentioning

confidence: 99%

Is Emergence Time Related to Emergence Agitation in Pediatric Patients?

pattaravit¹,

Karnjanawanichku²,

Siripruekpong³

et al. 2020

Preprint

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Background: Emergence agitation is one of the unpleasant symptoms after general anesthesia, especially in pediatric patients. This study was designed to evaluate the correlation between emergence time and emergence agitation. The predictors associated with emergence agitation and behavioral changes in children was also determined as specific outcomes.Methods: This prospective cohort study was conducted in children undergoing anesthesia between 3 to 12 years. The preoperative unit nurse evaluated the child's baseline behaviors preoperatively. From pre to post anesthesia period, nurse anesthetist recorded anesthetic management data and clinical emergence time. Meanwhile, the investigator team recorded the Processed-EEG emergence time. At the Post-Anesthetic Care Unit (PACU), the well trained PACU nurse evaluated clinical emergence time and emergence symptoms. For the behavioral symptoms, the investigator team evaluated any changes by telephone interview at postoperative days 1, 3, and 7. Statistical significance was set at p <0.05. Results: Ninety-one pediatric patients were enrolled in the study. Preoperative baseline behaviors were not related to emergence agitation or behavioral changes. There were correlations between clinical emergence time and the incidences of emergence agitation and postoperative separation anxiety. There was no relationship found between processed-EEG emergence time and the incidence of emergence agitation. Multivariate logistic regression analysis showed the significant predictors (ASA physical status, clinical emergence time, and pain) to predict Emergence agitation. (AUC=0.92, sensitivity = 0.89, specificity 0.81). Separation anxiety was significantly higher at postoperative days 1,3 and 7 in the children with emergence agitation (p-values = 0.020, 0.020, and 0.017, respectively).Conclusion: Clinical emergence time significantly related to emergence agitation and postoperative separation anxiety.Trial registration: ClinicalTrials.gov Identifier: NCT03358069. Registered 18 January 2017 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007IOW&selectaction=Edit&uid=U0001FGB&ts=2&cx=-7ofx36

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“…The metabolic activity of brain cells needs energy. Problems or changes in energy production (increased demand or decrease production) by brain cells can profoundly affect the EEG activity [10][11][12]. Monitoring of the level of consciousness during general anesthesia based on electroencephalography has become routine practice in the operating room.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

Rogobete¹,

Bedreag²,

Păpurică³

et al. 2020

Preprint

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Worldwide, an increasing number of patients undergo complex surgeries. With the development of general anesthesia techniques and anesthetic substances, the most complex surgical techniques could be developed. In order to adapt the anesthesia according to the particularities of each patient, it is recommended the multimodal monitoring of these patients. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, reduction of post-operative complications. Also, there is an important impact on the status of inflammation and the redox balance. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

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Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane

Abstract: NCT01077674.

Cited by 33 publications

References 28 publications

Erector spinae plane block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery

Erector spinae plane block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery

Is Emergence Time Related to Emergence Agitation in Pediatric Patients?

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

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