BIS Monitoring: Awareness and Catastrophic Events

Adam, Naureen; Sebel, Peter S.

doi:10.1177/108925320400800103

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…16 Noninvasive monitoring using bispectral analysis has been used to monitor sedation in order to reduce awareness, adjust drug doses and more readily assure patients of reduced awareness, but bispectral analysis during sedation is not foolproof in preventing awareness. [17][18][19][20][21][22][23][24] Palliative Sedation…”

Section: Awareness During Surgerymentioning

confidence: 99%

Does Palliative Sedation Always Relieve Symptoms?

Davis

2009

Journal of Palliative Medicine

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Palliative sedation is commonly used to treat refractory symptoms. A systematic review of guideline for palliative sedation suggested that mild sedation is preferred and the minimum amount of medication should be used. There is little objective evidence that sedation relieves symptoms because assessment of response is limited by the therapy. However, patient awareness during surgery occurs in 2%-3% of individuals of which the anesthesiologist is unaware. This results in a sense helplessness, acute fear, and panic. Awareness can occur in up to 17% of those undergoing conscious sedation. Seventeen percent of individuals who undergo palliative sedation fail to have symptoms relieved by sedation. Routine use of sedation scales should be used during palliative sedation to minimize treatment failure.

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Section: Awareness During Surgerymentioning

confidence: 99%

Does Palliative Sedation Always Relieve Symptoms?

Davis

2009

Journal of Palliative Medicine

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“…Es hat sich während der Untersuchung gezeigt, dass eine Standardnarkosedosierung keine ausreichende Narkosetiefe für eine Dichtigkeitsmessung garantieren kann, denn ein BIS-Wert <40 konnte nur erreicht werden, wenn wiederholt additive Propofolbolusgaben (0,5 mg/kgKG) erfolgten. Das BIS-Monitoring wurde für diese Untersuchung gewählt, da es sich hierbei um ein etabliertes Verfahren zur Narkosetiefemessung handelt [1].…”

Section: Dichtigkeitunclassified

Evaluation der neuen Kehlkopfmasken Ambu AuraOnce™ und Intersurgical i-gel™

et al. 2009

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“…Other studies have linked low and isoelectric BIS scores with delayed awakenings and documented intra-procedural cerebral ischemic infarctions. [ 20 ]…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

et al. 2015

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Introduction:Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass.Materials and Methods:In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5th edition). Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients.Results:When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF) patients scored significantly higher than the low-dose fentanyl (LDF) + dexmedetomidine (DEX) (LDF + DEX) group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046). The bispectral index (BIS) value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011). For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ) score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027).Conclusions:Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental outcome.

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BIS Monitoring: Awareness and Catastrophic Events

Cited by 8 publications

References 17 publications

Does Palliative Sedation Always Relieve Symptoms?

Does Palliative Sedation Always Relieve Symptoms?

Evaluation der neuen Kehlkopfmasken Ambu AuraOnce™ und Intersurgical i-gel™

Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

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