Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2016
Randomized Controlled TrialEvaluation of the brain anaesthesia response monitor during anaesthesia for cardiac surgery: a double-blind, randomised controlled trial using two doses of fentanyl.
The brain anaesthesia response (BAR) monitor uses a method of EEG analysis, based on a model of brain electrical activity, to monitor the cerebral response to anaesthetic and sedative agents via two indices, composite cortical state (CCS) and cortical input (CI). It was hypothesised that CCS would respond to the hypnotic component of anaesthesia and CI would differentiate between two groups of patients receiving different doses of fentanyl. Twenty-five patients scheduled to undergo elective first-time coronary artery bypass graft surgery were randomised to receive a total fentanyl dose of either 12 μg/kg (fentanyl low dose, FLD) or 24 μg/kg (fentanyl moderate dose, FMD), both administered in two divided doses. ⋯ Following the first dose of fentanyl, CI, CCS and BIS decreased in both groups. Following the second dose of fentanyl, there was a significant reduction in CI in the FLD group but not the FMD group, with no significant change found for BIS or CCS in either group. The BAR monitor demonstrates the potential to monitor the level of hypnosis following anaesthesia induction with propofol via the CCS index and to facilitate the titration of fentanyl as a component of balanced anaesthesia via the CI index.
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J Clin Monit Comput · Dec 2016
Randomized Controlled TrialChanges in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.
Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. ⋯ The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.
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J Clin Monit Comput · Dec 2016
Randomized Controlled TrialThe effect of anesthesia depth on the oculocardiac reflex in strabismus surgery.
The aim of this study was to investigate the effect of the bispectral index (BIS) guided depth of anesthesia to inhibition of the oculocardiac reflex (OCR) during pediatric strabismus surgery. Patients between the ages of 3 and 16 years who were scheduled for elective strabismus surgery were randomly assigned to two groups. In Group 1 (n: 32), the BIS values of the patients were maintained at <50; in Group 2 (n: 28), the BIS values of the patients were maintained at levels greater than or equal to 50 with 4-7 % desflurane in a 50 % O2-air mixture by titrating the concentration during the surgery. ⋯ Moreover, the incidence of OCR in group 2 was higher in medial rectus (MR) traction (78.9 %) than in lateral rectus (LR) traction (33.3 %) (p = 0.035), with no significant difference in Group 1 between MR (21.1 %) and LR (26.7 %) tractions (p = 0.83). We found that the lower BIS values are associated with the lower incidence of OCR in pediatric patients undergoing strabismus surgery. And our findings confirmed that the deeper anesthesia has a protective effect against the OCR.