High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring
| Autor: | Lucy Li, Evan Fitchett, Jamie Bloom, Tuan Trinh, David Wyler, Victor Romo, Marc C. Torjman, Michael E. Mahla, Amy Mehta, David Kastenberg |
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| Rok vydání: | 2020 |
| Předmět: |
Article Subject
medicine.diagnostic_test business.industry Sedation Colonoscopy Electroencephalography Critical Care and Intensive Care Medicine Propofol sedation 03 medical and health sciences Burst suppression 0302 clinical medicine Anesthesiology and Pain Medicine Anesthesiology Anesthesia Medicine 030211 gastroenterology & hepatology Observational study RD78.3-87.3 030212 general & internal medicine High incidence medicine.symptom business Propofol medicine.drug Research Article |
| Zdroj: | Anesthesiology Research and Practice Anesthesiology Research and Practice, Vol 2020 (2020) |
| ISSN: | 1687-6962 |
| Popis: | Background. Although anesthesia providers may plan for moderate sedation, the depth of sedation is rarely quantified. Using processed electroencephalography (EEG) to assess the depth of sedation, this study investigates the incidence of general anesthesia with variable burst suppression in patients receiving propofol for outpatient colonoscopy. The lessons learned from neuromonitoring can then be used to guide institutional best sedation practice. Methods. This was a prospective observational study of 119 outpatients undergoing colonoscopy at Thomas Jefferson University Hospital (TJUH). Propofol was administered by CRNAs under anesthesiologists’ supervision. The Patient State Index (PSi™) generated by the Masimo SedLine® Brain Root Function monitor (Masimo Corp., Irvine, CA) was used to assess the depth of sedation. PSi data correlating to general anesthesia with variable burst suppression were confirmed by neuroelectrophysiologists’ interpretation of unprocessed EEG. Results. PSi values of 50 (p=0.001). Mean total propofol dose was significantly correlated to patient PSi during periods of PSi R=0.406, p=0.021). Conclusion. Although providers planned for moderate to deep sedation, processed EEG showed patients were under general anesthesia, often with burst suppression. Anesthesiologists and endoscopists may utilize processed EEG to recognize their institutional practice patterns of procedural sedation with propofol and improve upon it. |
| Databáze: | OpenAIRE |
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