L’index «A-line ARX» peut être un détecteur plus sensible du réveil que l’index bispectral pendant l’anesthésie avec propofol-fentanyl-protoxyde d’azote: une recherche préliminaire

Nishiyama, Tomoki; Hanaoka, Kazuo

doi:10.1007/bf03018394

Cited by 17 publications

(18 citation statements)

References 25 publications

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“…Generally, it is considered that AAI 60-100 represents the normal waking state, 40-60 represents the sleep state, 30-40 represents the light anesthesia state, <30 represents the clinical anesthesia state and <10 represents the deep anesthesia state (22). It has been suggested that AAI can much more sensitively reflect the depth of anesthesia than the bispectral index in Pro-fentanyl anesthesia (23). The present study showed that the AAI of group A at T1 was decreased compared with that at T0 (P<0.05), and those of groups B, C and D at T1 were significantly lower than those at T0 (P<0.01); those of groups D and E at T3 were significantly increased compared with those at T2 (P<0.05).…”

Section: Discussionmentioning

confidence: 99%

Median effective concentration of remifentanil for the inhibition of laryngoscope-induced cardiovascular responses

ZhenHai

Wang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to calculate the median effective concentration (EC 50 ) of remifentanil (Rem) for the inhibition of laryngoscope-induced cardiovascular responses, and to observe its effects on the cardiovascular system and stress system. The study included 20 patients, who underwent time-scheduled vocal cord polyp resection with monitoring of heart rate (HR), mean blood pressure (MBP) and auditory evoked potential (AEP)-based A-line ARX Index (AAI). The Rem concentration was initially 5 ng/ml in the first patient, and the concentration selected for each subsequent patient was calculated from the previous case on the basis of whether or not cardiovascular reactions occurred. The HR, MBP and AAI at baseline, after the induction of anesthesia, and before and after the insertion of a self-retaining laryngoscope were recorded, with a change >15% recorded as a positive cardiovascular response. The EC 50 sequential method was used to calculate the EC 50 of Rem for the inhibition of laryngoscope-induced responses. Cortisol, interleukin-6 and blood glucose levels before and after laryngoscope insertion were also measured. The target-controlled concentrations for the 20 patients were as follows: 2 cases at 5 ng/ml, 6 cases at 4.2 ng/ml, 6 cases at 3.5 ng/ml, 4 cases at 2.9 ng/ml and 2 cases at 2.4 ng/ml. The EC 50 of Rem for the inhibition of laryngoscope-induced responses was 3.5 ng/ml with a 95% confidence interval (CI) of 3.47-3.60 ng/ml. A reasonable dose for inhibiting laryngoscope-induced responses was within the range 2.9-4.2 ng/ml. In conclusion, Rem exhibited an EC 50 of 3.5 ng/ml for the inhibition of laryngoscope-induced cardiovascular responses, with a 95% CI of 3.47-3.60 ng/ml, and a reasonable dose for the inhibition of such responses was 2.9-4.2 ng/ml.

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Section: Discussionmentioning

confidence: 99%

Median effective concentration of remifentanil for the inhibition of laryngoscope-induced cardiovascular responses

ZhenHai

Wang

et al. 2016

Experimental and Therapeutic Medicine

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“…Kurita [9] and Nishiyama [10] found that the MLA was able to predict movement following surgical incision and the insertion of a laryngeal mask, whereas BIS could not do this. These authors considered that this difference in the response occurred because BIS measures cortical and not subcortical activity, whereas MLAEP does reflect subcortical activity.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have investigated the ability of BIS and MLAEP to detect stimuli during anaesthesia for surgical operations, with conflicting results [9][10][11][12]. However, there are very few studies that have performed this evaluation in critically ill adults [13][14][15], and only one that has studied the use of BIS and the COMFORT scale following tracheal suctioning in critically ill children [16].…”

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confidence: 99%

Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children

et al. 2008

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SummaryWe performed simultaneous recordings of Bispectral Index (BIS) and middle latency auditory evoked potentials. We also recorded two clinical scales, the Modified Ramsay scale and the COMFORT scale. Heart rate and blood pressure were measured once a day, for a maximum of 5 days, in 81 critically ill children. Changes with tactile, auditory, and painful stimuli were analysed. All the stimuli significantly increased the BIS value, the painful stimulus having the greatest effect. The painful stimulus was the only one that altered the middle latency auditory evoked potentials. Although the responses of the clinical scales to stimuli were statistically significant, they were of little clinical relevance. None of the stimuli used significantly altered the heart rate or blood pressure. We conclude that tactile, auditory and painful stimuli produced changes of little relevance in the clinical scales, BIS or middle latency auditory evoked potentials. We found the BIS was the most sensitive method and the painful stimulus had the greatest effect.

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“…Anaesthetics or sedation alters EEG latency and amplitude (Drummond 2000;Thornton and Sharpe 1998) and these changes are used to generate the A-line ARX Index TM (AAI) (Mantzaridis and Kenny 1997). BIS and AAI have a range from zero, where patient's EEG is isoelectric, to 100, when patients are awake (Nishiyama and Hanaoka 2004;Rampil 1998). To achieve desired levels of anaesthesia or sedation, medications can be titrated according to the displayed index.…”

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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L’index «A-line ARX» peut être un détecteur plus sensible du réveil que l’index bispectral pendant l’anesthésie avec propofol-fentanyl-protoxyde d’azote: une recherche préliminaire

Abstract: P Pu ur rp po os se e: : To compare changes in the A-line ARX index (AAI) by the Alaris AEP monitor™ with those of the bispectral index (BIS) during propofol-fentanyl-nitrous oxide anesthesia.

Cited by 17 publications

References 25 publications

Median effective concentration of remifentanil for the inhibition of laryngoscope-induced cardiovascular responses

Median effective concentration of remifentanil for the inhibition of laryngoscope-induced cardiovascular responses

Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children

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

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