British journal of anaesthesia
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During EEG suppression with isoflurane or sevoflurane anaesthesia, median nerve stimulation causes cortical responses of two kinds: an N20 wave with a latency of 20 ms and an EEG burst with a latency of 200 ms. We tested the possibility that median nerve stimulation during EEG suppression with propofol would cause an EEG response that was consistent enough to be of use for neuromonitoring. ⋯ In addition to SSEP (somatosensory evoked potentials), three different evoked responses are noted that could be useful for clinical monitoring.
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Analysis of the bispectrum of EEG waveforms is a component of the proprietary BIS index-a commonly used commercial monitor of depth of anaesthesia. Does the use of the bispectrum give more information about depth of anaesthesia than the power spectrum? ⋯ We could not show that bispectral analysis gave more information than power spectral-based analysis. Most of the changes in the bispectral values result from decreases in the relative high frequency content of the EEG caused by anaesthesia.
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Fluid depletion during the perioperative period is associated with poorer outcome. Non-invasive measurement of total body water by bioimpedance may enable preoperative fluid depletion and its influence on perioperative outcome to be assessed. ⋯ Further work is warranted to determine if bioimpedance changes may serve as a useful indicator of perioperative fluid depletion.
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Case Reports
Postoperative nerve irritation syndrome after epidural analgesia in a six-year-old child.
Morbidity after paediatric epidural anaesthesia is unusual. We report a case of transient nerve root irritation occurring after epidural analgesia for radical nephrectomy in a 6-yr-old boy who received a continuous infusion of bupivacaine 0.1%. ⋯ Mechanical irritation of nerve roots by the epidural catheter in the epidural space is the most likely cause. Br J Anaesth 2004: 92: 146-8