The optimal anesthetic depth for interventional neuroradiology: comparisons between light anesthesia and deep anesthesia

Jung, Youjin; Han, Ye-Reum; Choi, Eun Su; Kim, Byung-Gun; Park, Hee Pyoung; Hwang, Jung‐Won; Jeon, Young-Tae

doi:10.4097/kjae.2015.68.2.148

Cited by 7 publications

(4 citation statements)

References 23 publications

(22 reference statements)

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“…The optimal BIS level during surgery has been reported to be between 40–50 [16,19]. A finding of the present study was that the total doses of propofol and remifentanil administered during surgery were significantly lower in the BIS group compared with the non-BIS group.…”

Section: Discussionsupporting

confidence: 51%

Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test

Zhou

Wang

2018

Med Sci Monit

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BackgroundBispectral index (BIS) monitoring can reduce the duration of anesthesia. This study aimed to evaluate the effects of BIS monitoring during surgery for resection of colon carcinoma in elderly patients using the Attention Network Test (ANT) to study alerting, orienting, and executive functions, and the Confusion Assessment Method (CAM).Material/MethodsEighty-one patients (65–75 years) underwent radical surgery for colon carcinoma with general intravenous anesthesia, propofol (6–8 mg/kg/h), vecuronium (0.03–0.05 mg/kg/min), and remifentanil (0.1–0.2 μg/kg/min). The BIS group (n=41) underwent adjustment of anesthesia to maintain a BIS value between 40–60; the non-BIS group (N=40) underwent standard intraoperative hemodynamic monitoring. Primary endpoints were alerting, orienting, and executive functions assessed pre-operatively and on postoperative days 1 and 5 using the ANT; the secondary endpoint was delirium during the first five postoperative days, assessed using the CAM.ResultsPropofol and remifentanil doses were significantly lower in the BIS group compared with the non-BIS group (P<0.001). Alerting, orienting, and executive functions showed no differences between the two groups pre-operatively but were impaired in both groups on postoperative day 1 compared with pre-operative levels (P<0.001). On postoperative day 5, alerting (P=0.607) and orienting (P=0.851) functions recovered in the BIS group but remained impaired in the non-BIS group (P<0.001). Delirium was significantly lower in the BIS group compared with the non-BIS group (17.5% vs. 27.5%) (P<0.001).ConclusionsBIS-guided anesthesia was associated with reduced anesthetic exposure, early postoperative recovery of alerting and orienting functions, and reduced postoperative delirium.

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Section: Discussionsupporting

confidence: 51%

Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test

Zhou

Wang

2018

Med Sci Monit

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“…The etiology of susceptibility to propofol is complex, involving complicated associations among drugs, biological and psychological factors 6 . More importantly, genetic components could play an essential role in the pathogenesis of susceptibility to propofol 7 .…”

Section: Introductionmentioning

confidence: 99%

Association of Polymorphisms in Pharmacogenetic Candidate Genes with Propofol Susceptibility

Zhong

Chen

Zhao

et al. 2017

Sci Rep

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Significant individual susceptibility to intravenous anesthetic propofol exists. The etiology of individual variability in the response to propofol may be influenced by genetic polymorphisms in metabolic and functional pathways. With current pharmacogenetics and modern molecular biology technologies, it is possible to study the influence of genetic polymorphisms on susceptibility to propofol. When inducing general anesthesia with intravenous propofol, high individual susceptibility to propofol was found. Using Sequenom MassARRAY single-nucleotide polymorphism (SNP) genotyping, we identified a mutation (rs6313) in the 5HT2A gene that was correlated to individual susceptibility to propofol effect-site concentration (Cep) and onset time of propofol induction. Carriers of the minor allele (G) of 5HT2A rs6313 required less propofol (20% decrease in Cep) and less time (40% decrease in onset time) to induce anesthesia. Moreover, associations were found between the gamma-aminobutyric acid (GABA) receptor SNP rs2279020 and the SCN9A SNP rs6746030 and the susceptibility of bispectral index (BIS) after propofol-induced anesthesia. In addition, dominant mutations in GABAA1 rs2279020, GABAA2 rs11503014, and CHRM2 rs1824024 were putatively associated with cardiovascular susceptibility to propofol anesthesia. No gene-gene interactions were found through a standardized measure of linkage disequilibrium and a multifactor dimensionality reduction analysis. Our results suggest that genetic polymorphisms related to mechanisms of propofol anesthesia are involved in propofol susceptibility.

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“…There is a general consensus to avoid nitrous oxide because of the risk of intravascular microbubbles during contrast injection [16]. It is desirable to assess the depth of anesthesia with cerebral neuromonitoring [30], but it is often not practical because of significantly disturbing imaging quality for the interventionalist. In addition, intraprocedural, INR patients are at high risk of hypothermia, and forced warming is needed [16].…”

Section: Intraprocedural Physiology and Anesthesiamentioning

confidence: 99%

Anesthesia care in the interventional neuroradiology suite: an update

Bello

Paisansathan

Riva

et al. 2022

Current Opinion in Anaesthesiology

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Purpose of reviewThe scope of procedures conducted by neurointerventionalists is expanding quickly, with lacking consensus over the best anesthesia modality. Although the procedures involve all age groups, the interventions may be complex and lengthy and may be provided in hospitals currently not yet familiar with the field. Here we review current literature addressing elective outpatient neurointerventional procedures and aim to provide an update on the management of intervention-specific crises, address special patient populations, and provide key learning points for everyday use in the neurointerventional radiology suite. Recent findingsVarious studies have compared the use of different anesthesia modalities and preinterventional and postinterventional care. Monitored anesthesia care is generally recommended for elderly patients, whereas children are preferably treated with general anesthesia. Additional local anesthesia is beneficial for procedures, such as percutaneous kyphoplasty and vascular access.

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The optimal anesthetic depth for interventional neuroradiology: comparisons between light anesthesia and deep anesthesia

Cited by 7 publications

References 23 publications

Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test

Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test

Association of Polymorphisms in Pharmacogenetic Candidate Genes with Propofol Susceptibility

Anesthesia care in the interventional neuroradiology suite: an update

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