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  • Blackwell Science Ltd  (4)
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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary We have studied the effects of nitrous oxide on the auditory evoked response index (AAI™-index) derived from the A-line monitoring device during sevoflurane anaesthesia in 21 patients undergoing minor ambulatory surgery. During sevoflurane anaesthesia with an AAI™-index 〈 30, the addition or withdrawal of nitrous oxide in a concentration of 66% end tidal did not show any linear dose dependent change in AAI™-index. However, comparing nitrous oxide 〉 40% to nitrous oxide 〈 10% end tidal concentration the AAI™-index did decrease, p 〈 0.05. The AAI™-index is either non-linear at deeper anaesthetic levels or is insensitive to the anaesthetic effects of nitrous oxide in terms of MAC-multiples.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary The bispectral index (BIS), auditory evoked potential index (AAITM) and the end-tidal sevoflurane concentration were studied during induction and emergence in 10 ASA I-II patients. Both during ‘wash-in’ and ‘wash-out’ of sevoflurane, the AAITM and BIS indices show huge variability and an overlap of indices between awake and not responding to command. This was the most pronounced during induction and the range of values was larger for the AAITM index as compared with the BIS index. Mean (range) BIS was 85 (73–98) and 48 (10–83) awake and unconscious, respectively, and mean AAITM index was 71 (43–99) and 21 (4–85), respectively. This study demonstrates the difficulties of using processed EEG variables in real time in a clinical situation of non-steady state pharmacodynamics.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The lack of a gold standard complicates the evaluation and comparison of anaesthetic depth monitors. This randomised study compares three different depth-of-anaesthesia monitors during cardiopulmonary bypass (CPB) at 34 °C with fentanyl/propofol anaesthesia adjusted clinically and blinded to the monitors. Coronary artery bypass grafting patients (n = 21) were randomly assigned to all three possible paired combinations of three monitors: Bispectral Index (Aspect Medical), AAITM auditory evoked potential (Danmeter), EntropyTM (Datex-Ohmeda). Indices were manually recorded every 5 min during CPB. Agreement between paired indices was classified as good, non-, or disagreement. Anaesthesia was classed as adequate, inadequate, or excessive according to recommended index values. Of the 255 paired indices recorded, 62% showed good agreement, 33% showed non-agreement, and 5% showed disagreement. Using good agreement between two monitors as a gold standard, a quarter of the measurements indicate inappropriate anaesthetic depth monitoring during CPB with clinically titrated anaesthetic depth.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The bispectral index (BIS) and the auditory evoked potential (AEP) index as calculated by the new A-line monitor were measured during hypnosis with propofol, which included an episode of wakefulness. Both indices followed a similar pattern during sedation, with values decreasing with sedation and increasing when awake. Baseline AEP values varied between 60 and 98, and BIS values were between 96 and 98. The AEP-index value was at all times 10–20 points lower than the BIS-index. The transition to loss of response occurred at a mean AEP value of 46 and BIS value of 58. The transition to just responding following a period of unconsciousness occurred at a mean AEP value of 46 and BIS 65. Both monitoring techniques, however, displayed large interindividual variations making it impossible to discriminate in real time between subtle changes of clinical state. The new neurophysiological monitors A-line AEP and BIS are interesting tools for creating a better understanding of the anaesthetic effects of drugs; however, further refinements are required before their relative roles can be fully established in the clinical setting.
    Type of Medium: Electronic Resource
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