Estimating anesthetic depth by electroencephalography during anesthetic induction and intubation in patients undergoing cardiac surgery
| Autor: | Avner Sidi, Shamay Cotev, Patrick Halimi |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
medicine.medical_specialty Cardiac output medicine.medical_treatment Electroencephalography Fentanyl medicine Intubation Intratracheal Intubation Humans Cardiac Surgical Procedures Randomized Controlled Trials as Topic medicine.diagnostic_test Dose-Response Relationship Drug business.industry Central venous pressure Hemodynamics Cardiac surgery Anesthesiology and Pain Medicine Blood pressure Anesthesia Anesthetic Mental Recall Anesthesia Intravenous business medicine.drug |
| Zdroj: | Journal of clinical anesthesia. 2(2) |
| ISSN: | 0952-8180 |
| Popis: | Intravenous (IV) anesthesia titrated to continuous computer-processed electroencephalograms (EEGs) was studied in 32 consecutive patients undergoing cardiac surgery. Anesthesia was induced with fentanyl 50 micrograms/kg with no EEG monitoring (n = 16) or 25 to 50 micrograms depending on changes in EEG (n = 16). EEG, oxygen saturation by pulse oximeter, intra-arterial blood pressure (BP), central venous pressure (CVP), and pulmonary artery pressure (PAP) (n = 18) were monitored continuously. Cardiac output (CO), CVP, PAP, spectral-edge frequency for each hemisphere, and BP were recorded before induction, immediately before intubation, and 1 and 5 minutes after intubation. With EEG monitoring, intubation was performed when spectral-edge frequency decreased to 10 Hz or less. Recall and pain were investigated 2 to 12 weeks postoperatively. With EEG, the amount of fentanyl used before intubation was significantly lower (39.7 +/- 2 micrograms/kg; p less than 0.005) than without EEG (50 micrograms/kg). The decrease in BP (% change) was less with than without EEG; mean changes in BP between preinduction and preintubation were -7.4% +/- 3.8% and -16.5% +/- 3.1% and between preinduction and 1 minute after intubation 0.3% +/- 3.4% and -12.5% +/- 3.5%, respectively. Percent changes in mean BP between intubation and 1 minute after were 9.6% +/- 4.0% with EEG and 5.2% +/- 3.0% without EEG. No patient in either group had recall. The authors conclude that using EEG monitoring to estimate depth of anesthesia during induction and laryngoscopy may increase safety in high-risk patients undergoing cardiac surgery. |
| Databáze: | OpenAIRE |
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