The Effect of Different End-tidal Desflurane Concentrations on Bispectral Index Values in Normal Children and Children with Cerebral Palsy

Yılbaş, Aysun Ankay; Ayhan, Banu; Akıncı, Seda Banu; Saricaoglu, Fatma; Aypar, Ülkü

doi:10.5152/tjar.2013.33

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Because the BIS is developed on the basis of studies conducted in patients with a normal EEG, its validity and reliability could be questionable in children with CP, who have central nervous system abnormalities. Previous studies have reported that the baseline BIS values in children with CP are similar to those in normal children at wakefulness, before premedication [7,8], but lower than the same after midazolam premedication [5,6]. During sevoflurane anesthesia, children with CP who had quadriplegia and mental retardation required lower anesthetic doses than those required in normal children, but exhibited a pattern in the change of the BIS scores similar to that observed in normal children [5].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have suggested that the BIS is also a valid monitoring tool for assessing the level of sedation in pediatric patients undergoing diagnostic or therapeutic procedures [5,6]. Previous studies have reported that the baseline BIS values in children with CP are similar to those in normal children at wakefulness, before premedication [7,8], but lower than the same after midazolam premedication [5,6]. In addition, children with CP required a lower propofol dose than that required in normal children to obtain the same BIS value during propofol anesthesia [7].…”

Section: Introductionmentioning

confidence: 99%

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Validity of bispectral index monitoring during deep sedation in children with spastic cerebral palsy undergoing injection of botulinum toxin

Jung

Lee

Park

2019

Korean J Anesthesiol

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An injection of botulinum toxin is commonly used to relieve spasticity and prevent contractures in children with spastic cerebral palsy (CP). Because of the pain associated with the injection and the inability for movement control during the procedure, the maintenance of deep sedation with effective analgesia is important so that the botulinum toxin can be accurately administered in the right muscle. However, because children may easily transit from deep sedation to general anesthesia with an increased risk of cardiorespiratory depression, a repeated and accurate assessment of the sedation level is necessary for the safety of children undergoing procedural sedation. Clinical Research ArticleBackground: This prospective study aimed to determine whether the bispectral index (BIS) is a valid objective tool for differentiating adequate from inadequate deep sedation in spontaneously breathing children with cerebral palsy (CP). Methods: Propofol was titrated to increase the level of sedation with a continuous infusion of remifentanil at a rate of 0.05 µg/kg/min while maintaining spontaneous ventilation in 22 children with spastic CP, aged 3-18 years. The depth of sedation was assessed using the University of Michigan Sedation Scale (UMSS) and the Modified Observer's Assessment of Alertness and Sedation (MOAAS) scale. Receiver operating characteristic curve analysis was performed to determine the cutoff BIS values for deep sedation, defined as a UMSS score of 3-4 and a MOAAS score of 0-1. Results:The BIS values significantly changed with the increase in the level of sedation across both the UMSS and MOAAS scores (P < 0.001). The BIS values correlated with the UMSS (r = −0.795, P < 0.001) and MOAAS (r = 0.815, P < 0.001) scores. The cutoff BIS value to detect adequate deep sedation in children with CP was 61.5 (UMSS score: sensitivity 0.860, specificity 0.814; MOAAS score: sensitivity 0.794, specificity 0.811). Conclusions:The BIS value strongly correlates with the clinical sedation scales, such as the UMSS and MOAAS, during deep sedation in children with CP. Therefore, BIS monitoring can be used as a valid tool for assessing the level of propofol sedation in spontaneously breathing children with CP undergoing a botulinum toxin injection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validity of bispectral index monitoring during deep sedation in children with spastic cerebral palsy undergoing injection of botulinum toxin

Jung

Lee

Park

2019

Korean J Anesthesiol

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The effect of bispectral index guided anesthesia versus standard practice on recovery after sevoflurane anesthesia in children: a prospective randomized double-blind clinical trial

Abdelzaam

Allazeem

Elbarbary

2020

Egyptian Journal of Anaesthesia

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Serebral Palsili Hastalarda Perkütan Endoskopik Gastrostomi Sırasında Uygulanan Prosedüral Sedasyon Uygulamaları

Kilicarslan

Gürbüz

Balkaya

et al. 2022

Black Sea Journal of Health Science

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Serebral palsili çocuklar sıklıkla var olan nörolojik hasar nedeniyle çiğneme ve yutma güçlüğü yaşamaktadır. Bu nedenle malnütrisyon için önemli bir risk grubunu oluştururlar. Fiziksel malformasyonları ve ek hastalıkları nedeniyle anestezi yönetimi diğer çocuk hastalara göre daha zordur. Çalışmamızda serebral palsili çocuklara yapılan perkütan endoskopik gastrostomi işlemleri sırasında ameliyathane dışı prosedüral sedasyon uygulamalarını değerlendirmeyi amaçladık. Mayıs 2017 ile Haziran 2021 tarihleri arasında ameliyathane dışında endoskopi ünitesinde prosedüral sedasyon ile perkütan endoskopik gastrostomi işlemlerinin gerçekleştirildiği 0-18 yaşları arasındaki hastalar retrospektif olarak değerlendirildi. Toplam 21 serebral palsili hasta ve 30 girişim değerlendirildi. Tüm hastalarda perkütan endoskopik gastrostomi uygulamasının temel endikasyonunu yutma güçlüğü ve malnütrisyon oluşturuyordu. Hastaların %26,6’sı (n=8) ASA skoru 2, %73,3’ü ise (n=22) ASA skoru 3 risk grubu olarak değerlendirildi. Hastaların %73,3’ünün (n=22) vücut ağırlığı

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The Effect of Different End-tidal Desflurane Concentrations on Bispectral Index Values in Normal Children and Children with Cerebral Palsy

Cited by 3 publications

References 19 publications

Validity of bispectral index monitoring during deep sedation in children with spastic cerebral palsy undergoing injection of botulinum toxin

Validity of bispectral index monitoring during deep sedation in children with spastic cerebral palsy undergoing injection of botulinum toxin

The effect of bispectral index guided anesthesia versus standard practice on recovery after sevoflurane anesthesia in children: a prospective randomized double-blind clinical trial

Serebral Palsili Hastalarda Perkütan Endoskopik Gastrostomi Sırasında Uygulanan Prosedüral Sedasyon Uygulamaları

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