Decrease of the peak heights of EEG bicoherence indicated insufficiency of analgesia during surgery under general anesthesia.

Background: Studies show that the two peak heights of electroencephalographic bicoherence (pBIC-high, pBIC-low) decrease after incision and are restored by fentanyl administration. We investigated whether pBICs are good indicators for adequacy of analgesia during surgery.

Methods: After local ethical committee approval, we enrolled 50 patients (27-65 years, ASA-PS I or II) who were scheduled elective surgery.

The arousal level of consciousness required for working memory performance: An anaesthesia study.

Regarding the stage of arousal level required for working memory to function properly, limited studies have been conducted on changes in working memory performance when the arousal level of consciousness decreases. This study aimed to experimentally clarify the stages of consciousness necessary for optimal working memory function. In this experiment, the sedation levels were changed step-by-step using anaesthesia, and the performance accuracy during the execution of working memory was assessed using a dual-task paradigm.

What are standard monitoring devices for anesthesia in future?

Monitoring the patient's physiological functions is critical in clinical anesthesia. The latest version of the Japanese Society of Anesthesiologists' Guidelines for Safe Anesthesia Monitoring, revised in 2019, covers various factors, including electroencephalogram monitoring, oxygenation, ventilation, circulation, and muscle relaxation. However, with recent advances in monitoring technologies, the information provided has become more detailed, requiring practitioners to update their knowledge.

Effect of remifentanil on three effect-site concentrations of propofol and their relationship during electroencephalography at loss of response, at maximum alpha power, and at onset of burst suppression: a prospective randomized trial.

Purpose: The effect-site concentration (Ce) at loss of response (Ce-LOR) to propofol closely correlates both with Ce as electroencephalographic alpha power becomes highest (Ce-alpha) and with Ce at onset of burst suppression (BS) (Ce-OBS), when no opioids are administered. Co-administration of opioids dose-dependently decreases Ce-LOR. We investigated the influence of remifentanil on the relationship between these three Ces.

The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients.

Purpose: The surgical Apgar score (SAS)-calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure-is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery.

Methods: We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS.

The pulmonary surgical Apgar score for lung cancer surgery predicts postoperative complications and long-term survival.

Objectives: The surgical Apgar score, calculated using 3 intraoperative variables (blood loss, lowest mean arterial pressure and lowest heart rate), is associated with mortality in cancer surgery. The original score has less applicability in lung cancer surgery; therefore, we innovated the modified pulmonary surgical Apgar score with additional intraoperative oxygen saturation representing pulmonary parenchymal damage and cardiopulmonary dynamics.

Methods: We retrospectively analysed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 at a single institute.

Equilibration rate constant, k, to determine effect-site concentration for the Masui remimazolam population pharmacokinetic model in general anesthesia patients.

Effect-site concentration is widely used to determine drug dosage in anesthesia practice. To obtain effect-site concentration, a pharmacokinetic model with a corresponding equilibration rate constant between plasma and effect-site, k, is necessary. Remimazolam, a novel short-acting benzodiazepine, has been approved as anesthetic/sedative.

Bi-national survey of Korea and Japan related to the injection site for ultrasound-guided stellate ganglion blocks and anatomic comparisons using cadaver dissection.

The aims of this study were to investigate the current clinical practice of ultrasound (US)-guided stellate ganglion block (SGB) using a bi-national survey of Korea and Japan, and to clarify the anatomical relation of the cervical sympathetic trunk with the prevertebral fascia at the level of cervical vertebrae. The current clinical practice of US-guided SGB in Korea and Japan was investigated using an Internet survey, which received 206 (10.2%) replies from Korea and 97 (8.

Use of Multiple EEG Features and Artificial Neural Network to Monitor the Depth of Anesthesia.

The electroencephalogram (EEG) can reflect brain activity and contains abundant information of different anesthetic states of the brain. It has been widely used for monitoring depth of anesthesia (DoA). In this study, we propose a method that combines multiple EEG-based features with artificial neural network (ANN) to assess the DoA.

New criteria of burst suppression on electroencephalogram in dogs anesthetized with sevoflurane.

Burst suppression on electroencephalogram (EEG) is defined as suppression periods longer than 0.5 s during which the amplitude does not exceed 5 μV in human. The aims of this study were; 1) an attempt of creating new criteria of burst suppression in dogs; and 2) a survey on accuracy of sub-parameter of Bispectral index (BIS).

Moderate sedation induced by general anaesthetics disrupts audio-spatial feature binding with sustained P3 components in healthy humans.

Feature binding is considered to be the basis for conscious stimulus perception, while anaesthetics exert a gradient effect on the loss of consciousness (LOC). By integrating these two streams of research, the present study assessed the effect of two anaesthetic agents (i.e.

Effects of sedation on subjective perception of pain intensity and autonomic nervous responses to pain: A preliminary study.

Rather than relying solely on subjective pain evaluation using means such as the visual analogue scale (VAS), in clinical situations it is possible to observe evoked responses of the autonomic nervous system (ANS) as objective indicators. Few studies, however, have reported these relationships under finely controlled sedation. 16 healthy male participants were administrated in intravenous sedation with either propofol or midazolam randomly.

Individual indicators of appropriate hypnotic level during propofol anesthesia: highest alpha power and effect-site concentrations of propofol at loss of response.

Background: Electroencephalogram (EEG) waveforms vary widely among individuals, this decreases the usefulness of BIS™ monitors for assessing the effects of propofol. Practically, anesthesia is only seen as too deep when evidence of burst-suppression is seen. We designed an experiment to help towards better assessment of individual anesthetic needs.

In vitro and in vivo effects of hemodilution on kaolin-based activated clotting time predicted heparin requirement using a heparin dose-response technique.

Purpose: The heparin dose-response (HDR) technique is based on activated clotting time (ACT) response to a fixed-dose heparin bolus, which varies substantially among patients. It is unclear, however, whether hemodilution-associated reductions in coagulation and anticoagulation factors affect the HDR slope.

Methods: For in vitro hemodilution, aliquots of whole blood from healthy volunteers were diluted 9:1 and 8:2 v/v with normal saline.

Sensory cognitive abnormalities of pain in autism spectrum disorder: a case-control study.

Background: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently included sensory processing abnormalities in the diagnostic criteria for individuals with autism spectrum disorder (ASD). However, there is no standard method for evaluating sensory abnormalities in individuals with ASD.

Methods: Fifteen individuals with ASD and 15 age- and sex-matched controls were enrolled in this study.

Rethinking general anesthesia for cesarean section.

In this review, we describe the current consensus surrounding general anesthetic management for cesarean section. For induction of anesthesia, rapid-sequence induction using thiopental and suxamethonium has been the recommended standard for a long time. In recent years, induction of anesthesia using propofol, rocuronium, and remifentanil have been gaining popularity.

[Preoperative Management of Patients with Bronchial Asthma or Chronic Bronchitis].

Bronchial asthma is characterized by chronic airway inflammation. The primary goal of treatment of asthma is to maintain the state of control. According to the Japanese guidelines (JGL2012), long-term management consists of 4 therapeutic steps, and use of inhaled corticosteroids (ICS) is recommended at all 4 steps.

Changes in the electroencephalogram during anaesthesia and their physiological basis.

The use of EEG monitors to assess the level of hypnosis during anaesthesia has become widespread. Anaesthetists, however, do not usually observe the raw EEG data: they generally pay attention only to the Bispectral Index (BIS™) and other indices calculated by EEG monitors. This abstracted information only partially characterizes EEG features.

Comparison of Bispectral Index and Entropy values with electroencephalogram during surgical anaesthesia with sevoflurane.

Background: Concomitantly recorded Bispectral Index® (BIS) and Entropy™ values sometimes show discordant trends during general anaesthesia. Previously, no attempt had been made to discover which EEG characteristics cause discrepancies between BIS and Entropy. We compared BIS and Entropy values, and analysed the changes in the raw EEG signal during surgical anaesthesia with sevoflurane.