Background: In intensive care, monitoring the depth of anesthesia during surgical procedures is a key element in the success of the medical operation and postoperative recovery. However, despite the development of anesthesia thanks to technological and pharmacological advances, its side effects such as underdose or overdose of hypnotics remain a major problem. Observation and monitoring must combine clinical observations (loss of consciousness and reactivity) with tools for real-time measurement of changes in the depth of anesthesia. . In this work, we will develop a noninvasive method for calculating, monitoring, and controlling the depth of general anesthesia during surgery. The objective is to reduce the effects of pharmacological usage of hypnotics and to ensure better quality recovery. Thanks to the overall activity of sets of neurons in the brain, we have developed a BIS technique based on bispectral analysis of the electroencephalographic signal EEG. . By collecting the electrical voltages from the brain, we distinguish light sleep from deep sleep according to the values of the BIS indicator (ranging from 0 : sleep to 100 : wake) and also control it by acting on the dosage of propofol and sevoflurane. We showed that the BIS value must be maintained during the operation and the anesthesia at a value greater than 60.
Conclusion: This study showed that the BIS technology led to an optimization of the anesthetic management, the adequacy of the hypnotic dosage, and a better postoperative recovery.
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http://dx.doi.org/10.1155/2021/9961998 | DOI Listing |
BJA Open
March 2025
Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Background: Intraoperative awareness, without explicit recall, occurs after induction of anaesthesia in approximately 10% of persons under 40 yr of age. Most anaesthetic agents minimally suppress the noradrenergic system. We hypothesised that addition of dexmedetomidine, which suppresses noradrenergic activity, may reduce encephalographic (EEG) arousal in response to tracheal intubation; such an effect would lay the foundation for future studies of dexmedetomidine in reducing intraoperative awareness.
View Article and Find Full Text PDFPerioper Med (Lond)
January 2025
Department of Anesthesia, Characteristic Medical Center of Chinese People's Armed Police Force (PAP), Tianjin, China.
Background: We investigated the consistency and accuracy of the Index of Consciousness (IoC) and the Bispectral Index (BIS) in monitoring the sedative effect of ciprofol during the induction of general anesthesia. There is extensive literature that reports good consistency and correlations between the IoC1 and the BIS in reflecting the sedation levels induced by propofol and sevoflurane but not by ciprofol.
Objective: The aim was to compare the consistency and accuracy of the IoC and BIS in monitoring the sedative effect of ciprofol during the induction of general anesthesia.
J Anaesthesiol Clin Pharmacol
May 2024
Department of Anaesthesiology and Critical Care, Lady Hardinge Medical College, New Delhi, India.
Paediatr Anaesth
January 2025
Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Background: In pediatric patients, the use of processed EEG monitoring may reduce the amount of anesthesia administered while maintaining adequate depth of anesthesia.
Aims: The primary aim of this study was to evaluate whether use of a BIS monitor to guide sevoflurane administration might reduce the average end tidal sevoflurane concentration used in children 4-18 years of age.
Methods: Participants in three age groups (4-8, 9-12, and 13-18 years) were randomized to either the BIS guided group or the control group.
Br J Anaesth
December 2024
Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
Background: The ability of current depth-of-anaesthesia monitors to differentiate subtle changes in the conscious state has not been well characterised. We examine the variability in bispectral index (BIS) scores associated with disconnected conscious and unconscious states as confirmed by a novel serial awakening paradigm.
Methods: Seventy adult participants, given propofol or dexmedetomidine, had a cumulative 1381 electroencephalographic (EEG) recordings across two centres.
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