Development and Clinical Application of Electroencephalographic Bispectrum Monitoring

Johansen, Jay W.; Sebel, Peter S.

doi:10.1097/00000542-200011000-00029

Cited by 501 publications

(326 citation statements)

References 54 publications

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“…4 Consequently, even 'light' sedation may result in procedural amnesia despite clinical sedation scores showing preserved responsiveness. 5 It is possible, therefore, that the incidence of recall may be equivalent between light and deep sedation protocols.…”

Section: Résumémentioning

confidence: 99%

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

Allen

Leslie

Hebbard

et al. 2015

Can J Anesth/J Can Anesth

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A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery Une étude randomisée contrôlée sur la sédation légère vs profonde au propofol pour la colonoscopie non urgente en ambulatoire: le souvenir, les conditions entourant l'intervention et la récupération sedation; P \ 0.0001). The incidence of recall was 12% in the light sedation group and 1% in the deep sedation group. The risk difference for recall was 0.11 (90% confidence interval, 0.05 to 0.17) in the intention-to-treat analysis, thus refuting equivalence in recall between light and deep sedation (0.05 significance level; 10% equivalence margin). Overall sedation-related complications were more frequent with deep sedation than with light sedation (66% vs 47%, respectively; P = 0.008). Recovery was more rapid with light sedation than with deep sedation as determined by the mean (SD) time to reach a score of 5 on the Modified Observer's Assessment of Alertness/Sedation Scale [3 (4) min vs 7 (4) min, respectively; P \ 0.001] and by the median [IQR] time to min, respectivement; P = 0.001). L'incidence des troubles cognitifs post-procéduraux était semblable chez les personnes randomisées à recevoir une sédation légère (19 %) ou profonde (16 %) (P = 0,554). Conclusion La sédation légère n'était pas équivalente à la sédation profonde en matière de souvenir de l'intervention, du spectre de complications ou des temps de récupération. Cette étude procure des données probantes nécessaires pour informer les patients concernant la sédation pour la colonoscopie. Cette étude a été enregistrée au Registre australien et néozélandais des études cliniques, no. 12611000320954.

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Section: Résumémentioning

confidence: 99%

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

Allen

Leslie

Hebbard

et al. 2015

Can J Anesth/J Can Anesth

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“…To achieve desired levels of anaesthesia or sedation, medications can be titrated according to the displayed index. Both monitors were developed using adult EEG data and calibrated during adult anaesthesia (Drummond 2000;Johansen and Sebel 2000;Tempe 2001) Intensive care researchers have investigated DoAMs to assess sedation levels for critically ill adults (De Deyne et al 1998;Simmons et al 1999). Using these monitors in adult intensive care however, remains controversial (Alexander and Duane 2005;Rinaldi et al 2006).…”

Section: Norwood Usa) and Alaris Auditory Evoked Potentials (Aep) Momentioning

confidence: 99%

A review of the utility of EEG depth of anaesthesia monitors in the paediatric intensive care environment

McKeever

Johnston

Davidson

2012

Intensive and Critical Care Nursing

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“…The BIS analyses artefact-free, non-suppressed segments of the EEG based on a mathematical analysis of the EEG of healthy adults undergoing general anaesthesia [32]. This monitor uses sensors with three or four self-adhesive electrodes applied to the skin of the forehead.…”

Section: Bispectral Indexmentioning

confidence: 99%

“…Values of BIS around 70 are considered appropriate [32]. A recent study found that the BIS was sensitive and specific for differentiating between light vs moderate and deep vs very deep sedation, but differentiated poorly the transition between moderate vs deep sedation [33].…”

Section: Bispectral Indexmentioning

confidence: 99%

“…One of the major sources of contamination of the BIS is the EMG; there is an overlap between the frontal EMG and the BIS at frequencies between 30 and 47 Hz, such that when muscle contraction occurs, BIS values increase even if there have been no changes in the conscious level [32,49,54]. It has been shown that the administration of neuromuscular blocking drugs to patients with deep sedation hardly alters BIS values, but when sedation is superficial, BIS values fall, suggesting that these drugs will have a direct effect on the conscious level in critically ill patients under moderate sedation [55].…”

Section: Limitations Of the Bismentioning

confidence: 99%

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Monitoring sedation in the critically ill child

Lamas

López‐Herce

2010

Anaesthesia

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SummarySedation is an essential part of the management of the critically ill child, and its monitoring must be individualised and continuous in order to adjust drug doses according to the clinical state. There is no ideal method for evaluating sedation in the critically ill child. Haemodynamic variables have not been found to be useful. Clinical scales are useful when sedation is moderate, but are limited by their subjective nature, the use of stimuli, and the impossibility of evaluating profoundly sedated patients or those receiving neuromuscular blocking drugs; in addition, many of these scales have not been evaluated in children. The COMFORT scale is the most appropriate, as it was designed and validated for critically ill children requiring mechanical ventilation. Electroencephalography‐derived methods permit continuous monitoring, provide an early indication of changes in the level of sedation, and facilitate a rapid adjustment of medication. However, these methods were designed and validated for patients under anaesthesia and their results cannot be fully extrapolated to the critically ill patient; in addition, some of them have not been validated in small children and there is still little experience in critically ill children. The main indications for the use of these methods are in patients with deep sedation and/or neuromuscular blockade. The bispectral index is the most widely used method at the present time. Analysis and comparison of the efficacy of the different methods for evaluating sedation in the critically ill child is required.

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Development and Clinical Application of Electroencephalographic Bispectrum Monitoring

Cited by 501 publications

References 54 publications

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

A review of the utility of EEG depth of anaesthesia monitors in the paediatric intensive care environment

Monitoring sedation in the critically ill child

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