Evaluation of the Sedline to Improve the Safety and Efficiency of Conscious Sedation

Caputo, Thomas D.; Ramsay, Michael A. E.; Rossmann, Jeffrey A.; Beach, M. Miles; Griffiths, Garth R.; Meyrat, Benjamin; Barnes, Jim; Kerns, David G.; Crump, Brad; Bookatz, Barnett; Ezzo, Paul

doi:10.1080/08998280.2011.11928715

Cited by 14 publications

(17 citation statements)

References 18 publications

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“…The administration of repeated doses in an attempt to prolong procedure duration is likely to create a risk for loss of swallowing reflexes or even the emergence of asphyxia. [10] In contrast, minor oral surgical procedures such as tooth extractions and phrenilectomies could be performed under CS.…”

Section: Discussionmentioning

confidence: 99%

“…Caputo et al also reported that the administration of additional doses of sedative in an attempt to prolong the duration of CS is likely to result in complications such as asphyxia and hypoventilation. [10] Moreover, dose escalation in dental treatment procedures performed under CS via the intravenous route in an office setting, not in a hospital, may lead to severe outcomes and even mortality. [12,13] Many sedatives and anesthetic agents are known to depress respiratory drive.…”

Section: Discussionmentioning

confidence: 99%

“…Hypoxemia is an important factor, especially in those under less-than-meticulous monitoring, and may give rise to severe complications leading to death, as mentioned above. [10] Midazolam at high doses is capable of exerting a depressive effect on the respiratory system. [10,12,13] The anesthesiologist in our study avoided the administration of additional doses of midazolam.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Midazolam at high doses is capable of exerting a depressive effect on the respiratory system. [10,12,13] The anesthesiologist in our study avoided the administration of additional doses of midazolam. Thus, the dental treatments performed under CS were limited to the affected teeth about which the patients complained and other treatments were skipped due to lack of time.…”

Section: Discussionmentioning

confidence: 99%

“…In the same regard, Rodger et al reported in their retrospective study that anesthesia-related complications occurred in only 1.57% of 3320 patients undergoing oral surgical procedures under sedation via the intravenous route. [14] GA can only be implemented in the hospital settings, [2,9,10] whereas CS can also be performed in an oral and dental health clinic, provided there is close monitoring by an anesthesiologist. [10] This may prompt a physician at a private dental clinic to favor CS.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Could conscious sedation with midazolam for dental procedures be an alternative to general anesthesia?

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Could conscious sedation with midazolam for dental procedures be an alternative to general anesthesia?

et al. 2013

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Modelling the PSI response in general anesthesia

Pérez

Torres

et al. 2020

J Clin Monit Comput

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In anesthesia automation, one of the main important issues is the availability of a reliable measurement of the depth of consciousness level (hypnosis) of the patient. According to this value, the hypnotic drug dosage can be adequately calculated. One of the most studied hypnosis indexes is the bispectral index (BIS). In this article we analyzed an alternative called patient state index (PSI). The objectives of this study are, first, to validate the accuracy of the PSI describing the hypnosis level during the maintenance phase of general anesthesia, by comparing with the BIS and, second, to model the relationship between propofol infusion rate and PSI values, obtained from a SEDLine monitor. For this, real data from patients undergoing general anesthesia simultaneously monitored with both BIS and PSI signals was used. Results obtained are interesting for a correct interpretation of PSI signal in clinical practice.

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Normative values for SedLine-based processed electroencephalography parameters in awake volunteers: a prospective observational study

Belletti

Naorungroj

Yanase

et al. 2020

J Clin Monit Comput

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Processed electroencephalography (pEEG) is used to monitor depth of anaesthesia and/or sedation. A novel device (Sed-Line®) has been recently introduced into clinical practice. However, there are no published data on baseline SedLine values for awake adult subjects. We aimed to determine baseline values for SedLine-derived parameters in eyes-open and eyes-closed states. We performed a prospective observational study in healthy volunteers. SedLine EEG-derived parameters were recorded for 2 min with eyes closed and 8 min with eyes open. We determined the overall reference range for each value, as well as the reference range in each phase. We investigated changes in recorded parameters between the two phases, and the interaction between EMG, baseline characteristics, and Patient State Index (PSI). We collected data from 50 healthy volunteers, aged 23-63 years. Median PSI was 94 (92-95) with eyes open and 88 (87-91) with eyes closed (p < 0.001 for open versus close). EMG activity decreased from 47.2% (46.6-47.9) with eyes open to 28.6% (28.0-29.3) with eyes closing (p < 0.001). There was a significant positive correlation between EMG and PSI with eyes closed (p = 0.01) but not with eyes open, which was confirmed with linear regression analysis (p = 0.01). In awake volunteers, keeping eyes open induces significant changes to SedLine-derived parameters, most likely due to increased EMG activity (e.g. eye blinking). These findings have implications for the clinical interpretation of PSI parameters and for the planning of future research.

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Evaluation of the Sedline to Improve the Safety and Efficiency of Conscious Sedation

Cited by 14 publications

References 18 publications

Could conscious sedation with midazolam for dental procedures be an alternative to general anesthesia?

Could conscious sedation with midazolam for dental procedures be an alternative to general anesthesia?

Modelling the PSI response in general anesthesia

Normative values for SedLine-based processed electroencephalography parameters in awake volunteers: a prospective observational study

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