Discrepant End-Tidal Concentrations of Sevoflurane at the Same A-Line Autoregressive Index Level during Induction of General Anesthesia: An Observational Study

Autor:	Ju-O Wang, Te-Chun Yeh, Shung-Tai Ho, Chih-Cherng Lu, Che-Hao Hsu, Tso-Chou Lin
Rok vydání:	2021
Předmět:	Mechanical ventilation A-line Autoregressive Index (AAI) business.industry medicine.medical_treatment Tracheal intubation sevoflurane General Medicine End tidal general anesthesia Sevoflurane Article Burst suppression Anesthesia Jugular bulb Anesthetic end-tidal concentration medicine Medicine business induction Young male medicine.drug
Zdroj:	Journal of Clinical Medicine Volume 10 Issue 19 Journal of Clinical Medicine, Vol 10, Iss 4526, p 4526 (2021)
ISSN:	2077-0383
Popis:	Background: The A-Line Autoregressive Index (AAI), which is derived from auditory evoked potentials, has been used for determining anesthetic depth. This study verified the correlation between AAI values and the corresponding end-tidal concentrations of sevoflurane during general anesthesia induction. Methods: Thirty young male adults undergoing elective minor orthopedic surgery were sequentially allocated to receive inspiratory 3%, 5%, or 6% sevoflurane for mask induction, followed by mechanical ventilation after tracheal intubation. The inspiratory, end-tidal and estimated jugular bulb concentrations of sevoflurane were recorded at three target AAI values: below 20, below 10, and at the start of burst suppression. Results: The mean time to loss of consciousness in the 6% sevoflurane group was shorter than that in the 5% and 3% groups however, the groups had comparable AAI values (range: 16–45). The 6% group had a higher end-tidal concentration (4.5% ± 0.2% vs. 3.8% ± 0.2%, p < 0.05) than did the 5% group, despite having the same target anesthetic levels by AAI score ≤10, whereas the estimated jugular bulb concentrations were comparable (1.9% vs. 1.9%) in both groups. Conclusions: Following mechanical ventilation with inspiratory 3%, 5%, or 6% sevoflurane, the end-tidal concentrations were discrepant at the same end points of AAI levels, despite similar estimated jugular bulb concentrations of sevoflurane. Thus, conventional alveolar concentration may overestimate anesthesia depth during rapid wash-in of sevoflurane.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5e1edbd3838df1dbdada420475071749 https://pubmed.ncbi.nlm.nih.gov/34640546 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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