A comparative study on adequate anesthesia depth: clinical judgement and the Narcotrend® measurement

Puchner, W.; Dünser, Martin W.; Paulus, Patrick; Neuner, M.; Mayer, Charlotte L; Pomberger, Irmgard M; Hackl, Ruth; Meier, Jens

doi:10.1007/s12630-020-01602-x

Cited by 7 publications

(7 citation statements)

References 41 publications

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“…Today, patients' anesthesia depth is mainly evaluated by the changes of basic indices such as HR and blood pressure, but these indices fluctuate widely due to the influence of personal physical state and psychological state [ 12 ]. Besides, the risk of anesthesia in elderly patients is significantly higher than that in young patients due to the decline of physical function and frequent complication of cardiovascular and cerebrovascular diseases [ 13 ]. Accordingly, it is necessary to choose an ideal mode of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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Objective. This research is designed to probe into the influence of Narcotrend- (NT-) assisted anesthesia in-depth monitor on cognitive impairment of elderly patients under general anesthesia (GA). Methods. One hundred and forty-four elderly patients with GA in our hospital from October 2020 to April 2021 were randomized into two groups, namely, NT group (supervised anesthesia under NT monitoring) and group C (anesthesia according to doctors’ experience). The heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded before surgery (T0), at the beginning of surgery (T1), at the end of surgery (T2), and 1 day after surgery (T3). Serum of patients was obtained at these four time points for measurements of C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol (Cor) levels using the enzyme-linked immunosorbent assay (ELISA). The alterations in cognitive function pre- and post-anesthesia were assessed using the mini-mental state examination (MMSE), and adverse events (AEs) during anesthesia recovery, postoperative recovery, and dosage of anesthetics were recorded. Results. At T1 and T2, MAP was higher and CVP was lower in NT group, versus group C. NT group presented higher CRP, IL-6, and Cor than group C at T1-T3. MMSE scores were higher in TN group than in group C at 12, 24, and 48 h after surgery. The incidence rates of postoperative cognitive dysfunction (POCD) and total AEs in group C were noticeably higher than those in NT group. Compared with group C, the time of anesthesia recovery, extubation, and postanesthesia care unit (PACU) residence in NT group reduced remarkably. Conclusions. NT has little effect on the physical condition of elderly patients under GA, and can reduce the dosage of narcotic drugs and promote the recovery of patients from anesthesia, which has high clinical value.

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Section: Discussionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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“…There was no language restriction. The references of the retrieved documents were tracked, and the documents that met the inclusion criteria were included (5,6).…”

Section: Detection Methodsmentioning

confidence: 99%

Systematic review and meta-analysis of the prognostic value of Narcotrend monitoring of different depths of anesthesia and different Bispectral Index (BIS) values for cognitive dysfunction after tumor surgery in elderly patients

Shi¹,

Chen²,

Ni³

et al. 2022

Ann Transl Med

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Background: To study the effect of Narcotrend monitoring on the incidence of early postoperative cognitive dysfunction (POCD) under different Bispectral Index (BIS) conditions and the effect of different depths of anesthesia on the incidence of POCD. Methods:We performed a literature search of the PubMed, Embase, OVID (database system made by Ovid Technologies, USA), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP Chinese Sci-tech Journals Database, Wanfang Data, etc. from the date of establishment of the database until December 31, 2020.Results: In the end, eighty articles were included, with a total of 714 patients. The meta-analysis results showed that four articles (255 patients) compared the state of deep anesthesia (BIS 30-40) with conventional anesthesia (BIS 40-60 earlier) after POCD. Also, the incidence of POCD on the first day after deep anesthesia [Narcotrend stage (NTS): negative correlation is currently the most appropriate egg description; Nd can subdivide the original electroencephalogram (EEG) into six stages 15 levels (Nd Sg, NTS), or A (state of wakefulness), state B0-B2 (sedated state), state C0-C2 (light anesthetic state), state D0-D2 (general anesthesia), state E0-E2 (deep anesthesia state), and state F0-F2 (burst suppression state)] was significantly lower than that of conventional anesthesia (NTS D0-D1) [odds ratio (OR) =0.21, 95% confidence interval (CI): 0.13-0.35, P<0.00001]. Moreover, the incidence of POCD in deep anesthesia (NTS E1) at 7 days after surgery was significantly lower than that of conventional anesthesia (NTS D0) (OR =0.45, 95% CI: 0.23-0.91, P=0.03), while the incidence of POCD 7 days after NTS D2 in conventional anesthesia was significantly lower than that of NTS D0 (OR =0.42, 95% CI: 0.24-0.71, P=0.001).Discussions: POCDs are thought to be the result of a combination of physical defects and precipitating factors in patients with their own physical impairments, and despite potential adverse effects, there is currently no consensus on the incidence of POCDs in patients with tumor, current risk factors, causes, and prevention strategies. Moreover, the level of evidence is low, and the deviation between different studies cannot be ruled out.

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“…ere was no language restriction. e references of the retrieved documents were tracked, and the documents that met the inclusion criteria were included [5,6].…”

Section: Detection Methodsmentioning

confidence: 99%

Meta-Analysis of the Prognostic Value of Narcotrend Monitoring of Different Depths of Anesthesia and Different Bispectral Index (BIS) Values for Cognitive Dysfunction after Tumor Surgery in Elderly Patients

Chen

2022

Journal of Healthcare Engineering

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Objective. To study the effect of Narcotrend monitoring on the incidence of early postoperative cognitive dysfunction (POCD) under different bispectral index (BIS) conditions and the effect of different depths of anesthesia on the incidence of POCD. Methods. We performed a literature search of PubMed, Embase, OVID (database system made by Ovid Technologies, USA), CBM (Chinese Biomedical Literature database), CNKI (China National Knowledge Infrastructure), Wanfang, and VIP databases (full-text database of Chinese sci-tech journals), etc., from the date of the establishment of the database until December 31, 2020. Our meta-analysis was focused on the collection and study of Narcotrend monitoring of different depths of anesthesia. We carefully read the abstracts and full texts of randomized controlled trials on the incidence of POCD in the early postoperative period, and their references were tracked. Data extraction and quality evaluation of the included literature were also performed, and RevMan 5.3 software was used for analysis. Results. In the end, eight articles were included, with a total of 714 patients. The meta-analysis results showed that four articles (255 patients) compared the state of deep anesthesia (BIS 30–40) with conventional anesthesia (BIS 40–60 earlier) after POCD. Also, the incidence of POCD on the first day after deep anesthesia (Narcotrend stage (NTS): negative correlation is currently the most appropriate EEG description; Nd can subdivide the original EEG into six stages and 15 levels (Nd Sg, NTS), namely, A (state of wakefulness) state, B0 B2 (sedated state), C0 C2 (light anesthetic state), D0 D2 (general anesthesia), and E0–E1) was significantly lower than that of conventional anesthesia (NTS DO–D1) (odds ratio (OR) = 0.21, 95% confidence interval (CI): 0.13–0.35, P < 0.00001 ). Moreover, the incidence of POCD in deep anesthesia (NTS E1) at 7 days after surgery was significantly lower than that of conventional anesthesia (NTS D0) (OR (odds ratio) = 0.45, 95% CI: 0.23–0.91, P = 0.03 ), while the incidence of POCD 7 days after NTS D2 in conventional anesthesia was significantly lower than that of NTS D0 (OR = 0.42, 95% CI: 0.24–0.71, P = 0.001 ). Discussion. Deep anesthesia can reduce the incidence of POCD (OR = 0.40, 95% CI: 0.22–0.73, P = 0.002 ). This meta-analysis included three studies (216 patients) that compared the early postoperative POCD incidence of BIS 40–50 under conventional anesthesia and BIS 50–60; the BIS 40–50 did not significantly reduce the incidence of POCD (OR = 1.11, 95% CI: 0.24–5.24, P = 0.9 ). The incidence of POCD under deep anesthesia with Narcotrend monitoring was lower than that under conventional anesthesia.

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A comparative study on adequate anesthesia depth: clinical judgement and the Narcotrend® measurement

Cited by 7 publications

References 41 publications

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Systematic review and meta-analysis of the prognostic value of Narcotrend monitoring of different depths of anesthesia and different Bispectral Index (BIS) values for cognitive dysfunction after tumor surgery in elderly patients

Meta-Analysis of the Prognostic Value of Narcotrend Monitoring of Different Depths of Anesthesia and Different Bispectral Index (BIS) Values for Cognitive Dysfunction after Tumor Surgery in Elderly Patients

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