Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2021
Observational StudyIntraoperative zero-heat-flux thermometry overestimates esophageal temperature by 0.26 °C: an observational study in 100 infants and young children.
In pediatric anesthesia, deviations from normothermia can lead to many complications, with infants and young children at the highest risk. A measurement method for core temperature must be clinically accurate, precise and should be minimally invasive. Zero-heat-flux (ZHF) temperature measurements have been evaluated in several studies in adults. ⋯ There was no significant or relevant change of temperature over time (0.006 °C per hour measurement interval, p = 0.199) and no relevant differences in the subgroups. Due to the mean bias of +0.26 °C in TZHF, the risk of hypothermia may be underestimated, while the risk of hyperthermia may be overestimated. Nevertheless, because of its high precision, we consider ZHF valuable for intraoperative temperature monitoring in children and infants.
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J Clin Monit Comput · Dec 2021
Clinical TrialComparison of the Conox (qCON) and Sedline (PSI) depth of anaesthesia indices to predict the hypnotic effect during desflurane general anaesthesia with ketamine.
Comparison of two depth of anesthesia indices, qCON (Conox) and PSI (Sedline), during desflurane sedation and their sensitivity to random ketamine boluses in patients undergoing routine surgery. The performance of desflurane and ketamine on both indices was analyzed for 11 patients, and the ketamine sensitivity was compared with another group of 11 patients under sevoflurane and propofol. The MOAA/S was used to determine sedation level and pain. ⋯ However, during desflurane anesthesia the qCON index did not change significantly after ketamine administration, qCON (before = 33 (4), after = 30 (17); Wilcoxon, p = 0.89), while the PSI experienced a significant increase, PSI (before = 31(6), after = 39(16) Wilcoxon, p = 0.013). This study shows that qCON and PSI have similar performance under desflurane with good discrimination between the awake and anesthetized states. While both indices exhibited similar behavior under ketamine boluses under a sevoflurane-propofol anesthesia, the qCON index had a better performance under ketamine during desflurane anesthesia.
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J Clin Monit Comput · Dec 2021
Comparative study of silicone membrane simulator and animal eye models for sub-Tenon's block.
To compare and assess silicone membrane-based sub-Tenon's block (STB) simulator and animal eye model (goat's eye) for practicing STB in terms of anatomical similarity and feel of texture of eye layers. The study included 34 participants (26 learners and 8 consultants) from tertiary ophthalmic centres. The participants were divided into groups A and B. ⋯ Overall, 89% participants preferred the simulator; the reasons included ease of usage, helpful warning system, absence of biological waste, and facility for repeatable training. The study validated anatomical accuracy, preference, and ability of usage of the STB simulator. For broader usage, further study involving higher number of participants is recommended.
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J Clin Monit Comput · Dec 2021
Observational StudyNormative values for SedLine-based processed electroencephalography parameters in awake volunteers: a prospective observational study.
Processed electroencephalography (pEEG) is used to monitor depth of anaesthesia and/or sedation. A novel device (SedLine®) has been recently introduced into clinical practice. However, there are no published data on baseline SedLine values for awake adult subjects. ⋯ There was a significant positive correlation between EMG and PSI with eyes closed (p = 0.01) but not with eyes open, which was confirmed with linear regression analysis (p = 0.01). In awake volunteers, keeping eyes open induces significant changes to SedLine-derived parameters, most likely due to increased EMG activity (e.g. eye blinking). These findings have implications for the clinical interpretation of PSI parameters and for the planning of future research.
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J Clin Monit Comput · Dec 2021
Application of a benchtop colorimetric method for quantification of blood propofol levels.
Quantification of plasma propofol (2,6-diisopropylphenol) in the context of clinical anaesthesia is challenging because of the need for offline blood sample processing using specialised laboratory equipment and techniques. In this study we sought to refine a simple procedure using solid phase extraction and colorimetric analysis into a benchtop protocol for accurate blood propofol measurement. The colorimetric method based on the reaction of phenols (e.g. propofol) with Gibbs reagent was first tested in 10% methanol samples (n = 50) containing 0.5-6.0 µg/mL propofol. Subsequently, whole blood samples (n = 15) were spiked to known propofol concentrations and processed using reverse phase solid phase extraction (SPE) and colorimetric analysis. The standard deviation of the difference between known and measured propofol concentrations in the methanol samples was 0.11 µg/mL, with limits of agreement of - 0.21 to 0.22 µg/mL. For the blood-processed samples, the standard deviation of the difference between known and measured propofol concentrations was 0.09 µg/mL, with limits of agreement - 0.18 to 0.17 µg/mL. Quantification of plasma propofol with an error of less than 0.2 µg/mL is achievable with a simple and inexpensive benchtop method.