PRISMA: accuracy of response entropy and bispectral index to predict the transition of consciousness during sevoflurane anesthesia

Liang, Tao; Wu, Fan; Wang, Baoguo; Feng, Mengyu

doi:10.1097/md.0000000000025718

Cited by 3 publications

(2 citation statements)

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“…Otra herramienta para medir la profundidad anestésica es la entropía, se acepta que existe una ligera ventaja del BIS sobre este monitor para determinar la profundidad anestésica (66) .…”

Section: Bis Y Otros Monitores De Profundidad Anestésica Y Conscienciaunclassified

Conciencia de la consciencia durante la anestesia

Suárez-Morales¹,

Mendoza-Popoca²

2022

Revista Mexicana De Anestesiología

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RESUMEN.La definición de consciencia en sí encierra una gran dificultad por su esencia y la inmensa complejidad de los numerosos componentes y procesos que la conforman. La consciencia como característica inherente al ser humano ha sido objeto de numerosos estudios y tratados, no sólo científicos, sino además filosóficos, religiosos, éticos, etcétera. Esto también incluye la diferencia entre consciencia y conciencia. La dificultad para poder establecer el principio que da origen a la consciencia, representa, por lo tanto, un gran reto para poder dilucidar con certeza lo que sucede con ésta durante el evento anestésico. Gracias al entendimiento que se va logrando a través de las investigaciones concernientes a las funciones de diferentes y complejas estructuras, tales como la substancia activadora reticular ascendente, el tálamo, partes del cuerpo estriado y la corteza cerebral, entre otras, que se relacionan gracias a la existencia de redes neuronales, integradas a su vez por nodos con funciones específicas y a la vez variadas, capaces de intercomunicar estas estructuras encefálicas, aun estando distantes, se tiene ahora nociones sólidas de dónde, cómo y cuánto se puede ver afectada la integración de la consciencia como consecuencia del efecto de los diferentes anestésicos.

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Section: Bis Y Otros Monitores De Profundidad Anestésica Y Conscienciaunclassified

Conciencia de la consciencia durante la anestesia

Suárez-Morales¹,

Mendoza-Popoca²

2022

Revista Mexicana De Anestesiología

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“…Sevoflurane inhalation anesthesia has been used for fiberoptic bronchoscopy in children because it induces rapid anesthesia without significantly affecting voluntary breathing. However, it has been reported that sevoflurane can easily lead to pediatric anesthesia emergence delirium (PAED), which is not conducive to children's postoperative recovery and may cause concern for parents (3). Esketamine, a novel intravenous anesthetic drug, is the dextro-isomer of ketamine.…”

Section: Introductionmentioning

confidence: 99%

Effect of Esketamine Applied in Fiberoptic Bronchoscopy on Negative Postoperative Behavioral Changes of Children

Zhang,

Yao,

Yang

et al. 2023

Iran J Pediatr

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Background: Fiberoptic bronchoscopy is currently the most commonly used invasive examination method in clinical practice. Objectives: This study aimed to assess the impact of esketamine administration during fiberoptic bronchoscopy on the occurrence of negative postoperative behavioral changes (NPOBCs) in children. Methods: Ninety children undergoing fiberoptic bronchoscopy were enrolled and randomly assigned to 3 groups: the control group (group C, n = 30), treatment group 1 (group D1, n = 30), and treatment group 2 (group D2, n = 30). Group C received intratracheal surface anesthesia and sevoflurane inhalation, along with an intravenous injection of 5 mL of normal saline. Group D1 received intratracheal surface anesthesia and sevoflurane inhalation in addition to an intravenous injection of 0.5 mg/kg of esketamine diluted to 5 mL. Group D2 received intratracheal surface anesthesia and sevoflurane inhalation, with an intravenous injection of 0.75 mg/kg of esketamine diluted to 5 mL. Results: The incidence of NPOBCs was lower in groups D1 and D2 compared to group C at 1, 7, 14, and 30 days after the examination (P < 0.05). The pediatric anesthesia emergence delirium (PAED) scores were lower in groups D1 and D2 than in group C, with group D2 scoring lower than group D1 (P < 0.05). Groups D1 and D2 had a longer time to awaken than group C (P < 0.05), with group D2 having a longer time than group D1. The face, legs, activity, cry, and consolability (FLACC) scores in groups D1 and D2 were significantly lower than in group C, and group D2 had a lower score than group D1 (P < 0.05). The incidence of adverse reactions was lower in groups D1 and D2 compared to group C, and the rate was even lower in group D2 than in group D1 (P < 0.05). Conclusions: Administration of esketamine at a dose of 0.75 mg/kg may yield better clinical outcomes.

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Consistency analysis of consciousness index and bispectral index in monitoring the depth of sevoflurane anesthesia in laparoscopic surgery

Huo,

Zhang,

Zheng

et al. 2024

PeerJ

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Background The Index of Consciousness (IoC) is a new monitoring index of anesthesia depth reflecting the state of consciousness of the brain independently developed by China. The research on monitoring the depth of anesthesia mainly focuses on propofol, and bispectral index (BIS) is a sensitive and accurate objective index to evaluate the state of consciousness at home and abroad. This study mainly analyzed the effect of IoC on monitoring the depth of sevoflurane anesthesia and the consistency and accuracy with BIS when monitoring sevoflurane maintenance anesthesia. Objective To investigate the monitoring value of the Index of Consciousness (IoC) for the depth of sevoflurane anesthesia in laparoscopic surgery. Methods The study population consisted of 108 patients who experienced elective whole-body anesthesia procedures within the timeframe of April 2020 to June 2023 at our hospital. Throughout the anesthesia process, which encompassed induction and maintenance using inhaled sevoflurane, all patients were diligently monitored for both the Bispectral Index (BIS) and the Index of Consciousness (IoC). We conducted an analysis to assess the correlation between IoC and BIS throughout the anesthesia induction process and from the maintenance phase to the regaining of consciousness. To evaluate the predictive accuracy of IoC and BIS for the onset of unconsciousness during induction and the return of consciousness during emergence, we employed receiver operating characteristic (ROC) curve analysis. Results The mean difference between BIS and IoC, spanning from the pre-anesthesia induction phase to the completion of propofol induction, was 1.3 (95% Limits of Agreement [−53.4 to 56.0]). Similarly, during the interval from the initiation of sevoflurane inhalation to the point of consciousness restoration, the average difference between BIS and IoC was 0.3 (95% LOA [−10.8 to 11.4]). No statistically significant disparities were observed in the data acquired from the two measurement methodologies during both the anesthesia induction process and the journey from maintenance to the regaining of consciousness (P > 0.05). The outcomes of the ROC curve analysis disclosed that the areas under the curve (AUC) for prognosticating the occurrence of loss of consciousness were 0.967 (95% CI [0.935–0.999]) for BIS and 0.959 (95% CI [0.924–0.993]) for IoC, with optimal threshold values set at 81 (sensitivity: 88.10%, specificity: 92.16%) and 77 (sensitivity: 79.55%, specificity: 95.45%) correspondingly. For the prediction of recovery of consciousness, the AUCs were 0.995 (95% CI [0.987–1.000]) for BIS and 0.963 (95% CI [0.916–1.000]) for IoC, each associated with optimal cutoff values of 76 (sensitivity: 92.86%, specificity: 100.00%) and 72 (sensitivity: 86.36%, specificity: 100.00%) respectively. Conclusion The monitoring of sevoflurane anesthesia maintenance using IoC demonstrates a level of comparability to BIS, and its alignment with BIS during the maintenance phase of sevoflurane anesthesia is robust. IoC displays promising potential for effectively monitoring the depth of anesthesia.

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PRISMA: accuracy of response entropy and bispectral index to predict the transition of consciousness during sevoflurane anesthesia

Cited by 3 publications

References 23 publications

Conciencia de la consciencia durante la anestesia

Conciencia de la consciencia durante la anestesia

Effect of Esketamine Applied in Fiberoptic Bronchoscopy on Negative Postoperative Behavioral Changes of Children

Consistency analysis of consciousness index and bispectral index in monitoring the depth of sevoflurane anesthesia in laparoscopic surgery

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