Absalom, Anthony R

Kalmar, Alain

Liley, DTJ

Sahinovic, Marco M

Shoushtarian, M

Struys, Michel

VEREECKE, HUGO

English

Ghent University Academic Bibliography

Print CloseA3145October 26, 2015 3:15:00 PM - 5:15:00 PMRoom Hall B2-Area BComparisons of Electroencephalographically Derived Measures of Hypnosis and Antinociception During Propofol-Remifentanil AnesthesiaMehrnaz Shoushtarian, Ph.D., Marko M. Sahinovic, M.D., Anthony R. Absalom, M.D., Alain Kalmar, M.D., Hugo E. Vereecke, M.D., David T. liley, M.B., Michel M. Struys, M.D.Cortical Dynamics Ltd., Melbourne, AustraliaDisclosures: M. Shoushtarian: A. Salary; Self; Cortical Dynamics Ltd.. E. Stock Options; Self; Holds options in Cortical Dynamics Ltd.. M.M. Sahinovic: None. A.R. Absalom: None. A. Kalmar: None. H.E. Vereecke: None. D.T. liley: A. Salary; Self; Co-founder and CSO of Cortical Dynamics Ltd.. E. Stock Options; Self; holds shares in Cortical Dynamics Ltd. M.M. Struys: H. Honoraria; Self; Speaker's honoraria from Covidien. I. Other Material Support; Self; Co-inventor of closed loop system used in this study.BackgroundNociception-induced arousal or movement during anesthesia, results from ascending sensory signals. Electroencephalogram (EEG) derived measures provide information on cortical activity and hypnosis but are less accurate regarding subcortical activity. The neurophysiologically-based EEG measures of Cortical Input (CI) and Cortical State (CS) have been shown to be prospective indicators of analgesia/anti-nociception and hypnosis respectively.1 In the current study we have compared CI and an alternate measure of CS, the Composite Cortical State (CCS), with the Bispectral Index (BIS) and another recently developed measure of anti-nociception, the Composite Variability Index (CVI). We aimed to evaluate the extent to which simple combinations of anti-nociceptive and hypnotic measures (rather than each measure individually) could better detect and predict response to stimulation.MethodsEEG recordings and time series of BIS and CVI from a previously published study,2 were reanalyzed. In the current study the data from 80 patients each randomized to a target hypnotic level (BIS 50 or BIS 70) and a target remifentanil level (Remi-0, 2, 4 or 6 ng/ml) was included in the analysis. CCS, CI, BIS and CVI were calculated or quantified at baseline and at a number of intervals following the application of the Observer’s Assessment of Alertness/Sedation scale (OAA/S) and a subsequent tetanic stimulus. Measures were compared before and after application of the stimuli. Statistical clustering methods were used to evaluate the extent to which simple combinations of anti-nociceptive and hypnotic measures (CCS/CI and BIS/ CVI) could better detect and predict response to stimulation.ResultsApplication of the OAA/S stimulus resulted in an increase in CI and CCS, whereas following both stimuli, an increase in all four measures was seen. Pairwise combinations of CI and CCS showed higher sensitivity (P = 0.006) and specificity (P = 0.0159) in predicting response to tetanic stimulation when compared to CVI and BIS combined.ConclusionsCombining EEG-derived hypnotic and analgesic quantifiers appears to enable better prediction of patients who are likely to respond to tetanic stimulation.References1. Liley et al. Anesthesiology 113 (2):292-3042. Sahinovic et al. Anesth Analg 119 (2):288-301Copyright © 2015 American Society of Anesthesiologistspagina 1 van 1ASA Abstracts - Print Article6/06/2016http://www.asaabstracts.com/strands/asaabstracts/printAbstract.htm;jsessionid=5B04F3...

Comparisons of electroencephalographically derived measures of hypnosis and antinociception during propofol-remifentanil anesthesia

https://biblio.ugent.be/publication/8642309/file/8642311.pdf

Comparisons of electroencephalographically derived measures of hypnosis and antinociception during propofol-remifentanil anesthesia

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