Document Detail


BIS - AAI and clinical measures during propofol target controlled infusion with Schnider's pharmacokinetic model.
MedLine Citation:
PMID:  17115013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The A-line autoregressive index (AAI) and the Bispectral Index Score (BIS) are two commercially available indexes of anesthetic depth widely used in clinical practice. The aim of the current study was to compare the accuracy of AAI, BIS, Schnider's predicted effect-site concentration of propofol (Ce propofol) to assess depth of anesthesia. METHODS: Forty-four patients scheduled for major elective abdominal surgery received target effect-site controlled infusion of propofol. Target effect-site (Ce propofol) was started at 1.5 mug/mL and increased every 4 min by 1.0 microg/mL until 5.5 microg/mL were achieved. At every step sedation level was estimated, using AAI, BIS, Observer's Assessment of Alertness/Sedation scale (OAA/S), loss of eyelash reflex and Ce propofol. RESULTS: We enrolled 44 patients, 20 males and 24 females, ASA I/II 18/26, 48+/-10 years, 68.2+/-9 kg, 165+/-7.1 cm, body mass index (BMI) 25+/-3.5. At increasing Ce propofol BIS-AAI values decreased progressively (BIS range 97-38) (AAI range 97-17). Values of BIS < or = 50, of AAI < or = 48 and of Ce propofol > or = 5.1 resulted in OAA/S=0, while values of BIS < or = 62, AAI < or = 53 and Ce propofol < or = 3.5 resulted in OAA/S=2. Loss of eyelash reflex occurred when values were BIS < or = 64 and AAI < or 61. CONCLUSION: BIS, AAI, propofol site effect concentration revealed information on sedation level and consciousness but no gold standard yet exists because of consistent overlap between ''conscious'' and ''not conscious'' states.
Authors:
E Iannuzzi; M Iannuzzi; G Viola; L Sidro; A Cardinale; M Chiefari
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Minerva anestesiologica     Volume:  73     ISSN:  0375-9393     ISO Abbreviation:  Minerva Anestesiol     Publication Date:    2007 Jan-Feb
Date Detail:
Created Date:  2007-03-14     Completed Date:  2007-05-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  23-31     Citation Subset:  IM    
Affiliation:
Department of Anesthesiological, Surgical and Emergency Sciences, Unit of Anesthesia and Intensive Care Medicine 2nd Service of Anaesthesia, 2nd University of Naples, Naples, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acoustic Stimulation
Adult
Anesthesia, Intravenous*
Anesthetics, Intravenous* / adverse effects
Electroencephalography / drug effects*
Evoked Potentials, Auditory / drug effects
Female
Humans
Linear Models
Male
Middle Aged
Monitoring, Intraoperative
Propofol* / adverse effects
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol

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