Age-dependent relationship between bispectral index and sedation level

Yamashita, Kazunori; Terao, Yoshiaki; Inadomi, Chiaki; Takada, Masafumi; Fukusaki, Makoto; Sumikawa, Koji

doi:10.1016/j.jclinane.2008.05.004

Cited by 22 publications

(11 citation statements)

References 16 publications

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“…The application of BIS in a study of monitoring the depth of anesthesia has attracted great attention [ 21 ]. Studies show that BIS can reflect the sedation of a variety of anesthetic drugs [ 22 ]. BIS can well reflect the depth of sedation of anesthetic drugs and is an accurate and sensitive index to evaluate the effect of anesthesia [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship betweenUGT1A9gene polymorphisms, efficacy, and safety of propofol in induced abortions amongst Chinese population: a population-based study

et al. 2017

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The present study aimed to investigate the influence of UGT1A9 gene polymorphisms on the efficacy of propofol in patients undergoing the painless induced abortion method. A total of 156 women seeking voluntary pregnancy termination procedures were selected for the study, and subsequently underwent painless induced abortions, following anesthesia by means of propofol administration. PCR-restriction fragment length polymorphism (PCR-RFLP) was performed to detect the polymorphisms of UGT1A9 gene at –440C/T, –1818C/T, and –1887T/G loci. The time, effect-site concentration, and bispectral index (BIS) for the Observer’s Assessment of Alertness/Sedation (OAA/S) (up to 4 points) were observed and recorded in patients following discontinuation of propofol. The time and effect-site concentration for BIS reaching 80 in patients following the discontinuation of propofol were observed and recorded. Postoperative observations of adverse reactions, such as nausea, vomiting, and respiratory depression were all made record of. In comparison with patients with UGT1A9 –440C/T CT and TT, those with UGT1A9 –440C/T CC displayed shorter durations of OAA/S by up to 4 points, shorter BIS times reaching 80, as well as higher corresponding effect-site concentrations. No significant differences were detected in the patients with –440C/T, –1818T/C, and –1887T/G in incidence of nausea, vomiting, and respiratory depression. The findings of the study highlighted correlation between UGT1A9 –440C/T gene polymorphisms and positive propofol efficacy in patients undergoing painless induced pregnancy termination procedures.

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Section: Discussionmentioning

confidence: 99%

Relationship betweenUGT1A9gene polymorphisms, efficacy, and safety of propofol in induced abortions amongst Chinese population: a population-based study

et al. 2017

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“…Several studies have demonstrated that BIS is not a sensitive tool for measuring sedation induced with spinal anesthesia [ 18 ]. Furthermore, it has age-dependent differences, [ 32 , 33 ]. Accordingly, we used BIS as an adjunctive for clinical reference to the OAA/S scale.…”

Section: Discussionmentioning

confidence: 99%

Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group

Kim

et al. 2015

BMC Anesthesiol

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BackgroundDexmedetomidine (DMT), a highly selective α2-adrenoceptor agonist, has been used safely as a sedative in patients under regional anesthesia. The purpose of this study was to determine the 50% effective dose (ED50) of single-dose DMT to induce adequate light sedation in elderly patients in comparison with younger patients undergoing transurethral resection of the prostate (TURP) with spinal anesthesia.MethodsForty-two male patients were recruited. The young age group (Group Y) included patients 45 to 64 years old and the old age group (Group O) included patients 65 to 78 years old. After the spinal anesthesia was performed, a pre-calculated dose of DMT was administered for 10 min. The Observer’s Assessment of Alertness/Sedation (OAA/S) scale, bispectral index score (BIS) were assessed then at 2-min intervals for 20 min. A modified Dixon’s up-and-down method was used to determine the ED50 of the drug for light sedation (OAA/S score 3/4). In the recovery room, regression times of the motor and sensory blocks were recorded.ResultsThe ED50 of DMT was 0.25 (95% C.I. 0.15-0.35) μg/kg in Group O and 0.35 (95% C.I. 0.35-0.45) μg/kg in Group Y (p = 0.002). The ED95 was 33% lower in Group O compare with Group Y (0.38 (95% C.I. 0.29-0.39) μg/kg vs. 0.57 (95% C.I. 0.49-0.59) μg/kg). The regression time of sensory block was longer in Group O than in Group Y (109.0 ± 40.2 min vs. 80.0 ± 31.6 min) (p = 0.014).ConclusionThe single-dose of DMT for light sedation was lower by 21% in Group O compare with Group Y underwent TURP with spinal anesthesia.Trial registrationClinicalTrials.gov identifier: NCT01665586. Registered July 31, 2012.

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“…In one pivotal study [183], fully awake subjects were shown to achieve BIS scores below 50 (i.e., corresponding with BIS during general anesthesia) when dosed with NMB drugs alone. Furthermore, additional research has suggested that BIS values should be interpreted with caution when patients are children [184], elderly [185], have known neurological disorders, or are taking psychoactive medications [186]. Beyond BIS, it has been noted that, "the use of DoA monitors remains a major controversy in anesthesiology.…”

Section: A Monitoringmentioning

confidence: 99%

Physiological Closed-Loop Control (PCLC) Systems: Review of a Modern Frontier in Automation

et al. 2020

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Over the past decade, there has been an unprecedented international focus on improved quality and availability of medical care, which has reignited interest in clinical automation and drawn researchers toward novel solutions in the field of physiological closed-loop control systems (PCLCs). Today, multidisciplinary groups of expert scientists, engineers, clinicians, mathematicians, and policy-makers are combining their knowledge and experience to develop both the next generation of PCLC-based medical equipment and a collaborative commercial/academic infrastructure to support this rapidly expanding frontier. In the following article, we provide a robust introduction to the various aspects of this growing field motivated by the recent and ongoing work supporting two leading technologies: the artificial pancreas (AP) and automated anesthesia. Following a brief high-level overview of the main concepts in automated therapy and some relevant tools from systems and control theory, we explore -separately -the developments, challenges, state-ofthe-art, and probable directions for AP and automated anesthesia systems. We then close the review with a consideration of the common lessons gleaned from these ventures and the implications they present for future investigations and adjacent research.

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Age-dependent relationship between bispectral index and sedation level

Cited by 22 publications

References 16 publications

Relationship betweenUGT1A9gene polymorphisms, efficacy, and safety of propofol in induced abortions amongst Chinese population: a population-based study

Relationship betweenUGT1A9gene polymorphisms, efficacy, and safety of propofol in induced abortions amongst Chinese population: a population-based study

Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group

Physiological Closed-Loop Control (PCLC) Systems: Review of a Modern Frontier in Automation

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