Original Article
Identifying consciousness alterations during intravenous anesthesia with the depth of anesthesia index and bispectral index: a randomized multicenter study
Fu Yang, Xu Tao, Xie Keliang, Wei Wei, Gao Ping, Nie Huang, Deng Xiaoming, Wang Guolin, Tian Ming, Yan Min, Dong Hailong, Yue Yun
Published 2018-11-15
Cite as Int J Anesth Resus, 2018,39(11): 1005-1009. DOI: 10.3760/cma.j.issn.1673-4378.2018.11.002
Abstract
ObjectiveTo evaluate the validity of the depth of anesthesia index (Ai), based on sample entropy of electroencephalogram, in identifying the status of the consciousness during total intravenous anesthesia.
MethodsEEG electrode strips for recording Ai and BIS were randomly positioned on the left or right side of each patient′s forehead. Target-controlled infusion of propofol was increased by 0.5 mg/L per minute in a stepwise manner until loss of consciousness (LOC) was achieved. Values of Ai, BIS and estimated effect-site concentration (Ce) of propofol were recorded and analyzed during induction and emergence of general anesthesia. Logistic regression was used to analyze the relationship between consciousness state and values of Ai or BIS.
ResultsOne hundred and forty four patients in six medical centers were enrolled and have accomplished this protocol safely. In patients at LOC, the values of Ai and BIS were 61±12 and 62±11, which were respectively reduced by 15.0% and 9.3% one minute after LOC. When patients regained consciousness (ROC), Ai and BIS respectively reached 74±14 and 76±8, and increased by 15.0% and 7.0%, correspondingly, one minute after ROC. The estimated values of Ai and BIS were 48.3 and 52.3 for 95% LOC, and were 55.7 and 63.1 for 5% ROC.
ConclusionsAt LOC, ROC, estimated 50% LOC and 50% ROC, the values of Ai and BIS were close to each other and they are equivalent for clinical monitoring. When consciousness states altered, changes of Ai were significantly greater than those of BIS. It suggests that Ai is a better parameter to estimate alterations of consciousness state.
Key words:
Loss of consciousness; Recovery of consciousness; Total intravenous anesthesia; Depth of anesthesia index; Bispectral index
Contributor Information
Fu Yang
Department of Anesthesiology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
Xu Tao
Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Xie Keliang
Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin 300052, China
Wei Wei
Department of Anesthesiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
Gao Ping
Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310009, China
Nie Huang
Department of Anesthesiology, Xijing Hospital Affiliated to the Fourth Military Medical University, Xi′an 710032, China
Deng Xiaoming
Faculty of Anesthesiology, Changhai Hospital, Naval Military Medical University, Shanghai 200433, China
Wang Guolin
Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin 300052, China
Tian Ming
Department of Anesthesiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
Yan Min
Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310009, China
Dong Hailong
Department of Anesthesiology, Xijing Hospital Affiliated to the Fourth Military Medical University, Xi′an 710032, China
Yue Yun
Department of Anesthesiology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
