The prediction probabilities for emergence from sevoflurane anesthesia in children: A comparison of the perfusion index and the bispectral index

Li, Peipei; Wu, Chi; Wu, Jun-Zheng; Zhang, Mazhong; Zheng, Jijian; Shen, Yang; He, Pan; Sun, Ying

doi:10.1111/pan.13324

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…However, PLE values rose faster than BIS values from ROC to full recovery of orientation, and at full recovery of orientation, the PLE value reached the preanesthetic value, whereas the BIS value remained approximately 12 lower than baseline. These results are consistent with those of an earlier study, which reported that the BIS value reached approximately 85% of the preoperative baseline value at awakening 30. Failure of BIS to return to the preanesthetic value at full recovery of orientation suggests a potential difference between PLE and BIS with respect to their sensitivity to residual concentrations of anesthetics.…”

Section: Discussionsupporting

confidence: 91%

Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring

et al. 2019

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Background Most depth of anesthesia (DOA) monitors rely on the temporal characteristics of a single-channel electroencephalogram (EEG) and cannot provide spatial or connectivity information. Phase lag entropy (PLE) reflects DOA by calculating diverse connectivity from temporal patterns of phase relationships. The aim of this study was to compare the performance of PLE and bispectral index (BIS) monitors for assessing DOA during anesthesia induction, nerve integrity monitoring (NIM), and anesthesia emergence. Methods Thirty-five patients undergoing elective thyroid surgery with recurrent laryngeal nerve NIM received propofol and remifentanil via target-controlled infusion. After applying PLE and BIS monitors, propofol infusion was initiated at a calculated effect site concentration (Ce) of 2 µg/mL and then increased in 1-µg/mL Ce increments. After propofol Ce reached 5 μg/mL, a remifentanil infusion was begun, and anesthesia induction was considered complete. During NIM, PLE and BIS values were compared at a specific time points from platysma muscle exposure to subcutaneous tissue closure. PLE and BIS values were recorded continuously from preanesthetic state to full recovery of orientation; bias and limits of agreement between monitors were calculated. Results PLE and BIS values decreased progressively with increasing propofol Ce during anesthetic induction and increased by stages during emergence. The prediction probabilities of PLE and BIS for detecting propofol Ce changes were 0.750 and 0.756, respectively, during induction and 0.749 and 0.746, respectively, during emergence. No aberrant PLE or BIS values occurred during NIM. Correlation coefficients for BIS and PLE were 0.98 and 0.92 during induction and emergence, respectively. PLE values were significantly higher than BIS values at full recovery of orientation. Estimated bias between monitors was −4.16 ± 8.7, and 95% limits of agreement were −21.21 to 12.89. Conclusion PLE is a reasonable alternative to BIS for evaluating consciousness and DOA during general anesthesia and during NIM. Trial Registration Clinical Research Information Service Identifier: KCT0003490

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Section: Discussionsupporting

confidence: 91%

Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring

et al. 2019

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“…Several studies have compared the performance of different EEG-derived monitors and other monitors in the patients. [6,14,22,23] Most of these studies reported comparable prediction probabilities for the different monitor types. In the present study, BIS and PSI yielded similar prediction probabilities for distinguishing the maintenance state from recovery state in children.…”

Section: Discussionmentioning

confidence: 99%

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

Jang

Kim

et al. 2020

Preprint

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Background: Cortical electroencephalography (EEG)-based devices are used to monitor the depth of anesthesia. In this study, we compared the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the maintenance and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of two monitors.Methods: Fifty children (3-12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Maintenance state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. The prediction probability (Pk), agreement or correlation of BIS and PSI in different anesthesia state were calculated.Results: Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% Confidential Interval (CI) [0.78-0.91])) and PSI (95% CI [0.82-0.91]) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for maintenance state.Conclusions: Pk values were comparable for BIS and PSI. Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population.Trial Registry Number: Clinical Trials.gov NCT03792334.

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“…Several studies have compared the performance of different EEG-derived monitors and other monitors in the patients. [6,14,21,22] Most of these studies reported comparable prediction probabilities for the different monitor types. In the present study, BIS and PSI yielded similar prediction probabilities for distinguishing the steady state from recovery state in children.…”

Section: Discussionmentioning

confidence: 99%

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

Jang

Kim

et al. 2020

Preprint

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Background: Cortical electroencephalography (EEG)-based devices are used to monitor the depth of anesthesia. In this study, we compared the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the steady and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of two monitors. Methods: Fifty children (3-12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Steady state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. The prediction probability (Pk), agreement or correlation of BIS and PSI in different anesthesia state were calculated. Results: Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% confidential interval (CI) [0.78-0.91])) and PSI (95% CI [0.82-0.91]) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for steady state. Conclusions: Pk values were comparable for BIS and PSI. Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population. Trial Registry Number: Clinical Trials.gov NCT03792334.

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The prediction probabilities for emergence from sevoflurane anesthesia in children: A comparison of the perfusion index and the bispectral index

Abstract: Both the perfusion index and bispectral index performed comparably well in predicting awakening and different arousal levels when emerging from sevoflurane anesthesia in children.

Cited by 11 publications

References 24 publications

Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring

Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

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