Document Detail

Validation of the index of consciousness during sevoflurane and remifentanil anaesthesia: a comparison with the bispectral index and the cerebral state index.
MedLine Citation:
PMID:  18723856     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The purpose of this study was to validate a new level of consciousness monitor derived from the EEG, called the index of consciousness (IoC), by comparing it with the bispectral index (BIS) and the cerebral state index (CSI) during general anaesthesia for cardiac surgery using sevoflurane, remifentanil, and atracurium. METHODS: After ethical committee approval and written patient consent, data from 35 patients [31 males, four females, age 55 (10) yr] were recorded during general anaesthesia for elective cardiac bypass surgery. All patients were induced with sevoflurane 8%, until the Observer's Assessment of Alertness and Sedation (OAAS) scale level 1 was reached, and then was set at a 1% end-tidal sevoflurane concentration. Subsequently, remifentanil and atracurium were administered, the trachea was intubated, and the procedure continued as usual. To assess accuracy, the prediction probability (Pk) was calculated both during induction and during maintenance. RESULTS: The Pk values [mean (se)] for IoC, BIS, and CSI during induction were 0.90 (0.01), 0.90 (0.01), and 0.88 (0.01), respectively, whereas the corresponding Pk values during maintenance were 0.95 (0.01), 0.94 (0.01), and 0.60 (0.01). CONCLUSIONS: The three indices performed equally well during the induction phase and were able to predict the level of consciousness of the patients satisfactorily. During maintenance, the IoC and the BIS showed good agreement with the clinical signs. The CSI was significantly influenced by the administration of atracurium; therefore, the agreement with the OAAS scale during the maintenance phase was significantly less for CSI than for IoC and BIS.
M Revuelta; P Paniagua; J M Campos; J A Fernández; A Martínez; M Jospin; H Litvan
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies     Date:  2008-08-23
Journal Detail:
Title:  British journal of anaesthesia     Volume:  101     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-15     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  653-8     Citation Subset:  IM    
Anaesthesia Research Group, Cardiac Anaesthesia and Postoperative Intensive Care Unit, Hospital Santa Creu i Sant Pau, Antonio Maria Claret 167, 08025 Barcelona, Spain.
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MeSH Terms
Anesthetics, General / pharmacology*
Anesthetics, Inhalation / pharmacology
Anesthetics, Intravenous / pharmacology
Atracurium / pharmacology
Consciousness / drug effects*
Coronary Artery Bypass
Electroencephalography / drug effects,  methods
Methyl Ethers / pharmacology
Middle Aged
Monitoring, Intraoperative / instrumentation,  methods*
Neuromuscular Nondepolarizing Agents / pharmacology
Piperidines / pharmacology
Reg. No./Substance:
0/Anesthetics, General; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 0/Neuromuscular Nondepolarizing Agents; 0/Piperidines; 132875-61-7/remifentanil; 28523-86-6/sevoflurane; 64228-79-1/Atracurium

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