| Title |
Prevalence of discordant elevations of state entropy and bispectral index in patients at amnestic sevoflurane concentrations: a historical cohort study
|
|---|---|
| Published in |
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, March 2018
|
| DOI | 10.1007/s12630-018-1085-3 |
| Pubmed ID | |
| Authors |
Richard H. Epstein, Joni M. Maga, Michael E. Mahla, Eric S. Schwenk, Marc J. Bloom |
| Abstract |
Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed. At the hospital using SE, all cases were included with patients ≥ 18 yr and sevoflurane administered for at least 30 min during surgery. A cohort of cases propensity matched by age and American Society of Anesthesiologist Physical Status were selected from the hospital using BIS. Elevated discordant EEG indices were defined as values > 70 occurring during stable end-tidal sevoflurane concentrations > 1.5%. The odds ratio (OR) based on the probability of a case having at least one elevated discordant SE or BIS lasting ≥ two minutes (primary endpoint) was calculated. At each hospital, 3,690 cases were studied. The mean (95% confidence interval [CI]) incidence of cases with at least one interval of an elevated discordant EEG index lasting at least two minutes was 3.6% (2.8% to 4.4%) for SE compared with 0.24% (0.17% to 0.27%) for BIS (pooled OR, 17.0; 95% CI, 8.3 to 34.7; P < 0.001). The prevalence of an elevated discordant EEG index is much greater with SE than with BIS. Elevated index values occurring at anesthetic concentrations well above the awareness threshold need to be assessed to determine if they indicate an inadequate depth of anesthesia requiring treatment or if they simply reflect the underlying monitoring algorithm. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Peru | 1 | 14% |
| Canada | 1 | 14% |
| Unknown | 5 | 71% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 86% |
| Science communicators (journalists, bloggers, editors) | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 23 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 22% |
| Student > Ph. D. Student | 4 | 17% |
| Other | 3 | 13% |
| Student > Doctoral Student | 3 | 13% |
| Professor | 1 | 4% |
| Other | 2 | 9% |
| Unknown | 5 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 35% |
| Engineering | 2 | 9% |
| Psychology | 2 | 9% |
| Unspecified | 1 | 4% |
| Agricultural and Biological Sciences | 1 | 4% |
| Other | 4 | 17% |
| Unknown | 5 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 September 2018.
All research outputs
#8,538,940
of 25,382,440 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#1,392
of 2,879 outputs
Outputs of similar age
#140,985
of 348,822 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#30
of 36 outputs
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