Journal of clinical monitoring and computing
-
J Clin Monit Comput · Dec 2006
The influence of sevoflurane on the bispectral index, regional cerebral oxygen saturation, and propofol concentration during propofol/N2O anesthesia.
This study was undertaken to investigate the influence of sevoflurane on the bispectral index (BIS), regional cerebral oxygen saturation (rSO(2)), and serum propofol concentration during propofol/N(2)O anesthesia. This study tested the hypothesis that sevoflurane affect BIS values, rSO(2), and the pharmacokinetics of propofol during propofol/ N(2)O anesthesia. ⋯ We have shown that sevoflurane decreases BIS values during propofol/N(2)O anesthesia without affecting rSO(2) and that this change is accompanied by an increase in serum propofol concentration. Changes in propofol concentration may be due to, at least in part, hemodynamic changes such as decreased CO produced by sevoflurane.
-
J Clin Monit Comput · Dec 2006
Comparative StudyCorrelation of Bispectral Index with Glasgow Coma Score in mild and moderate head injuries.
Bispectral Index (BIS) derived from electroencephalogram (EEG) is primarily developed to monitor the depth of unconsciousness. Recent evidence suggests that BIS may also help in the detection of cerebral ischemia and prognostication of outcome of traumatic brain injury (TBI). The present study was designed to investigate the correlation between Glasgow Coma Score (GCS) and BIS in mild and moderate head injury. ⋯ In patients with mild and moderate head injury, significant correlation exists between GCS and BIS. But the high degree of scatter of BIS values for any given GCS score limits its use as a monitor of depth of coma in TBI. Further studies are required to understand the relation between BIS algorithm and cerebral electrical activity following TBI to define the role of BIS as an electrophysiological correlate of consciousness in TBI.
-
J Clin Monit Comput · Oct 2006
ReviewIntraoperative motor evoked potential monitoring: overview and update.
Amidst controversy about methodology and safety, intraoperative neurophysiology has entered a new era of increasingly routine transcranial and direct electrical brain stimulation for motor evoked potential (MEP) monitoring. Based on literature review and illustrative clinical experience, this tutorial aims to present a balanced overview for experienced practitioners, surgeons and anesthesiologists as well as those new to the field. ⋯ The many advances in motor system assessment achieved in the last two decades undoubtedly improve monitoring efficacy without unduly compromising safety. Future studies and experience will likely clarify existing controversies and bring further advances.
-
The purpose of this study was to develop an interactive software package of alarm sounds to present, recognize and share problems about alarm sounds among medical staff and medical manufactures. ⋯ We have developed an interactive software package of alarm sounds by integrating the database and the alarm sound simulator (URL: http://info.ahs.kitasato-u.ac.jp/tkweb/alarm/asdb.html ). The AlmSS was useful for replaying multiple alarm sounds simultaneously and designing new alarm sounds interactively.
-
J Clin Monit Comput · Aug 2006
Randomized Controlled TrialResponse entropy is more reactive than bispectral index during laparoscopic gastric banding.
There is a potential use for spectral entropy or bispectral index (BIS) for controlling level of anesthesia, but it is not known how these EEG monitors relate during steady state anesthesia. We compared Response Entropy (RE) and BIS during anesthesia for laparoscopic gastric banding with RE targeted to 45. ⋯ Within the range of 41-44, RE and BIS are equal but the gain of RE is 0.5 greater than BIS with deeper or lighter anesthesia. This is not likely due to increased smoothing with BIS. Identifying periods of RE activation show that BIS, EMG and RE increase together.