Effect of neuromuscular blockade on the bispectral index in critically ill patients

Sanavia, Eva; García, Mirian; Castillo, Jimena del; González, Rafael; López‐Herce, Jesús; Mencía, Santiago

doi:10.1016/j.anpede.2019.07.003

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…Future research in the PICU setting could potentially explore the utility of the NI to measure hypnotic depth during neuromuscular blockade in critically ill children. EEG-based monitoring during neuromuscular blockade is recommended and currently assessed by BIS monitoring [ 33 , 34 , 35 , 36 ]. However, it has not been proven that BIS is the best measure to titrate sedation in settings where clinical sedation scales cannot be used.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Comfort Score and Narcotrend Index during Procedural Sedation with Midazolam and Propofol in Children

Bruns,

Joist,

Joist

et al. 2024

JCM

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Background/Objectives: Precise assessment of hypnotic depth in children during procedural sedation with preserved spontaneous breathing is challenging. The Narcotrendindex (NI) offers uninterrupted information by continuous electrocortical monitoring without the need to apply a stimulus with the risk of assessment-induced arousal. This study aimed to explore the correlation between NI and the Comfort Scale (CS) during procedural sedation with midazolam and propofol and to identify an NI target range for deep sedation. Methods: A prospective observational study was conducted on 176 children (6 months to 17.9 years) undergoing procedural sedation with midazolam premedication and continuous propofol infusion. Statistical analyses included Pearson correlation of NI and CS values, logistic regression, and receiver operating curves. Results: Median NI values varied with CS and age. The correlation coefficient between CS and NI was 0.50 and slightly higher in procedure-specific subgroup analyses. The optimal NI cut-off for deep sedation was between 50 and 60 depending on the analyzed subgroup and displayed high positive predictive values for sufficient sedation throughout. Conclusion: Our study found a moderate correlation between NI and CS, demonstrating reliable identification of adequately sedated patients.

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Section: Discussionmentioning

confidence: 99%

Correlation of Comfort Score and Narcotrend Index during Procedural Sedation with Midazolam and Propofol in Children

Bruns,

Joist,

Joist

et al. 2024

JCM

View full text Add to dashboard Cite

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“… 7 The unreliability of commonly used sedation scales in conditions where the patient is nonresponsive due to muscle relaxation leads to various objective methods of assessment. The objective methods of assessing sedation in mechanically ventilated patients are Bispectral Index (BIS), 8 Entropy, 9 Narcotrend, 10 and others.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Quantium Consciousness Index and Richmond Agitation Sedation Scale in Mechanically Ventilated Critically Ill Patients: An Observational Study

Sharma¹,

Bhatia²,

Harsha³

et al. 2022

Indian Journal of Critical Care Medicine

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A bstract Background The quantium consciousness index (qCON), an electroencephalography (EEG)-based modality, has no studies regarding intensive care unit (ICU) sedation, though very few studies describe its use for assessing depth of anesthesia in the operation theater. In this study, we evaluated qCON for assessing sedation compared with Richmond Agitation Sedation Scale (RASS) in patients on a mechanical ventilator in the ICU. Materials and methods Eighty-seven mechanically ventilated patients aged between 18 and 60 years were investigated over a 12-hour period. They were given a standardized dosage of sedation comprised of a bolus dose of propofol 0.5 mg/kg and fentanyl 1 µg/kg, and then infusions of propofol 2–5 mg/kg/hour and fentanyl 0.5–2 µg/kg/hour. These drug infusions were adjusted to achieve a RASS score between 0 and −3. Using the qCON monitor, the investigator recorded the qCON values and then assessed the RASS score. Results A total of 1,218 readings were obtained. After contrasting each qCON value correspondingly with time to each RASS value, we found their correlation to be statistically significant (ρ = 0.288, p <0.0001). With the help of receiver operating characteristic (ROC) curves, we were able to differentiate appropriate from inappropriate levels of sedation. A qCON value of 80 had a sensitivity of 72.67% and a specificity of 67.42% (AUC 0.738 with SE 0.021). Conclusion qCON can be used for assessing sedation levels in mechanically ventilated critically ill patients. Clinical trial registration CTRI/2019/07/020064. How to cite this article Harsha MS, Bhatia PK, Sharma A, Sethi P. Comparison of Quantium Consciousness Index and Richmond Agitation Sedation Scale in Mechanically Ventilated Critically Ill Patients: An Observational Study. Indian J Crit Care Med 2022;26(4):491–495.

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Effect of neuromuscular blockade on the bispectral index in critically ill patients

Cited by 2 publications

References 22 publications

Correlation of Comfort Score and Narcotrend Index during Procedural Sedation with Midazolam and Propofol in Children

Correlation of Comfort Score and Narcotrend Index during Procedural Sedation with Midazolam and Propofol in Children

Comparison of Quantium Consciousness Index and Richmond Agitation Sedation Scale in Mechanically Ventilated Critically Ill Patients: An Observational Study

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