Cerebral vasculitis as a rare cause of low bispectral index values

Prabhakar, Hemanshu; Ali, Zulfiqar; Hassan, Neelofar; Moses, Edmund J.

doi:10.1016/j.jclinane.2009.04.006

Cited by 1 publication

(1 citation statement)

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“…Intraoperative EEG provides a global assessment of cerebral ischemia but cannot be used to monitor the posterior fossa (22). Furthermore, lower BIS values in cerebral coil embolization can occur due to unexpected situations such as cerebral vasculitis (23). The probable confounding effect of the patients’ non-ruptured intracranial aneurysm on EEG tracing and PSI values may exist.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Methods of Anesthesia Using Patient State Index: Propofol Versus Sevoflurane During Interventional Neuroradiology Procedure

2019

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Background Over the past few decades, interventional neuroradiology (INR) has been a rapidly growing and evolving area of neurosurgery. Sevoflurane and propofol are both suitable anesthetics for INR procedures. While the depth of anesthesia is widely monitored, few studies have examined the patient state index (PSI) during clinical neuroanesthesia. Objectives This study aimed to investigate the differences in PSI values and in hemodynamic variables between sevoflurane anesthetic and propofol anesthetic during INR procedures. Methods We reviewed the medical charts of the patients who underwent embolization of a non-ruptured intracranial aneurysm by a single operator at a single university hospital from May 2013 to December 2014. Sixty-five patients were included and divided into two groups: S group (sevoflurane anesthesia, n = 33) vs. P group (propofol anesthesia, n = 32). The PSI values, hemodynamic variables, and use of hemodynamic drugs between two groups were analyzed. Results There were significant differences between the PSI values obtained through different perioperative stages in the two groups (P < 0.0001). During the procedure, the PSI values were significantly lower in the P group than in the S group (P = 0.000). The P group patients had a more prolonged extubation time (P = 0.005) and more phenylephrine requirement than the S group patients (P = 0.007). More anti-hypertensive drugs were administered to the patients in the S group during extubation (P = 0.0197). Conclusions The PSI can be used to detect changes in anesthetics concentration and in the depth of anesthesia during INR procedures. Although the extubation was faster under sevoflurane anesthetic, propofol anesthetic showed rather smoother recovery.

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Section: Discussionmentioning

confidence: 99%