Occurrence of and risk factors for electroencephalogram burst suppression during propofol-remifentanil anaesthesia

Autor: Mariette Mercier, Nathalie Boichut, E. Samain, C. Pericard, Ngai Liu, Guillaume Besch, S. Pili-Floury, T. Chazot
Přispěvatelé: Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Rok vydání: 2011
Předmět:
Male
MESH : Retrospective Studies
MESH : Piperidines
MESH : Aged
[ SDV.CAN ] Life Sciences [q-bio]/Cancer
0302 clinical medicine
Piperidines
MESH: Risk Factors
030202 anesthesiology
Risk Factors
Odds Ratio
MESH : Female
General anaesthesia
Propofol
MESH: Aged
MESH: Middle Aged
MESH : Hemodynamics
MESH: Anesthesia
General
Age Factors
Electroencephalography
MESH : Adult
Middle Aged
MESH : Risk Factors
Anesthetics
Combined
3. Good health
Burst suppression
MESH: Piperidines
MESH: Propofol
Anesthesia
Bispectral index
Female
MESH : Anesthetics
Combined
MESH: Anesthetics
Intravenous
Anesthetics
Intravenous
medicine.drug
MESH : Anesthetics
Intravenous
Adult
MESH: Hemodynamics
MESH : Male
MESH : Sex Factors
MESH: Monitoring
Intraoperative
Remifentanil
[SDV.CAN]Life Sciences [q-bio]/Cancer
Anesthesia
General
03 medical and health sciences
Sex Factors
MESH: Sex Factors
Monitoring
Intraoperative
MESH: Electroencephalography
Post-hoc analysis
medicine
Humans
MESH : Middle Aged
MESH : Propofol
MESH : Electroencephalography
MESH : Anesthesia
General
Aged
Retrospective Studies
MESH: Age Factors
MESH: Humans
business.industry
MESH : Humans
Hemodynamics
MESH: Adult
MESH: Retrospective Studies
Odds ratio
MESH: Male
MESH: Odds Ratio
Confidence interval
Anesthesiology and Pain Medicine
MESH : Monitoring
Intraoperative
MESH : Odds Ratio
MESH : Age Factors
MESH: Anesthetics
Combined
business
MESH: Female
030217 neurology & neurosurgery
Zdroj: BJA
BJA, 2011, 107 (5), pp.749-756. 〈10.1093/bja/aer235〉
BJA, 2011, 107 (5), pp.749-756. ⟨10.1093/bja/aer235⟩
ISSN: 1471-6771
DOI: 10.1093/bja/aer235〉
Popis: International audience; BACKGROUND: Suppression ratio (SR) derived from bispectral index (BIS) monitoring is correlated to EEG burst suppression. It may occur during deep anaesthesia, but also in the case of metabolic or haemodynamic brain injury. The goal of the study was to describe the occurrence of SR and to determine factors associated with SR during propofol-remifentanil general anaesthesia maintenance. METHODS: We conducted a post hoc analysis of BIS recordings in consecutive patients included in two multi-centre trials, undergoing non-cardiac surgery using a dual closed-loop BIS controller allowing automated propofol-remifentanil administration. The percentage of time spent with a BIS value between 40 and 60 (T(BIS 40-60)) was measured. Two groups of patients were defined: the SR group, including patients with at least one episode of SR value >10% lasting more than 1 min, and the control group. Factors associated with SR were analysed using a stepwise multivariate analysis. RESULTS: A total of 1494 patients [age=57 (17) yr; T(BIS 40-60)=76 (17%)] were analysed and 131 (8.7%) patients constituted the SR group. The main independent factors associated with SR were advanced age [odds ratio (95% confidence interval)=4.80 (1.85-12.43) (P=0.027), 10.59 (3.76-29.81) (P80 yr, respectively], history of coronary artery disease (CAD) [2.53 (1.47-4.37) (P=0.001)] and male gender [1.57 (1.03-2.40) (P=0.03)]. CONCLUSIONS: The occurrence of SR during BIS-controlled propofol and remifentanil anaesthesia is mainly observed in elderly male patients or in patients with a history of CAD. The mechanisms underlying SR and the potential consequences for the patient's postoperative outcome remain unsolved.
Databáze: OpenAIRE
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