Deep Sedation

Publication Title: 
Annales Francaises D'anesthesie Et De Reanimation

Analgesia and hypnosis are two separate entities and should result in distinct assessment and management for patients admitted to an intensive care unit (ICU). Those patients are exposed to moderate-severe pain and they are likely to remember pain as one bothersome experience. Any cause of patient discomfort is sought with the priority given to pain and adequate analgesia. Assessing pain must rely upon the use of clinical scoring systems, although these instruments are still underused in ICU.

Author(s): 
Payen, J.-F.
Chanques, G.
Publication Title: 
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference

An alternative statistic, the D-value, is presented for the evaluation of the performance of EEG-based depth-of-hypnosis measures against the Observers' Assessment of Alertness/Sedation scale. The measures considered here are spectral entropy, approximate entropy, Lempel-Ziv complexity and Higuchi fractal dimension. The study is based on recordings from 45 patients, divided into three groups of 15 recordings each. Patients of Group I received no remifentanil while patients of Groups II and III received 2 and 4 ng/ml effect compartment controlled remifentanil.

Author(s): 
Lipping, Tarmo
Ferenets, Rain
Mortier, Eric P.
Struys, Michel M. F.
Publication Title: 
Der Anaesthesist

One of the most important mandates of the anaesthesiologist is to control the depth of anaesthesia. An unsolved problem is that a straight definition of the depth of anaesthesia does not exist. Concerning this it is rational to separate hypnosis from analgesia, from muscle relaxation and from block of cardiovascular reactions. Clinical surrogate parameters such as blood pressure and heart rate are not well-suited for a valid statement about the depth of hypnosis. To answer this question the brain has become the focus of interest as the target of anaesthesia.

Author(s): 
Schmidt, G. N.
Müller, J.
Bischoff, P.
Publication Title: 
Annales Françaises D'anesthèsie Et De Rèanimation

Analgesia and hypnosis are two separate entities and should result in distinct assessment and management for patients admitted to an intensive care unit (ICU). Those patients are exposed to moderate-severe pain and they are likely to remember pain as one bothersome experience. Any cause of patient discomfort is sought with the priority given to pain and adequate analgesia. Assessing pain must rely upon the use of clinical scoring systems, although these instruments are still underused in ICU.

Author(s): 
Payen, J.-F.
Chanques, G.
Publication Title: 
Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie

PURPOSE: Deep anesthesia during microvascular decompression (MVD) for trigeminal neuralgia and cerebral aneurysm clipping may delay emergence. A new electroencephalographic (EEG) monitor, the EEGo, processes a raw EEG signal using time-delay analysis to display a reproducible signal transition from deep anesthesia through the excitement state to the awake state. We hypothesized that the EEGo monitor would be superior to the bispectral (BIS) monitor, not only in aiding emergence but also in detecting sudden changes in levels of hypnosis.

Author(s): 
Pauls, Ryan J.
Dickson, Timothy J.
Kaufmann, Anthony M.
Cappellani, Ronald B.
Ringaert, Kenneth R. A.
West, Michael
Silvaggio, Joseph A.
Wilkinson, Marshall F.
Girling, Linda G.
Mutch, W. Alan C.
Publication Title: 
Journal of Clinical Pharmacology

This study established the pharmacokinetic and pharmacodynamic relationships of the bispectral index (BIS) and Observer's Assessment of Alertness/Sedation (OAA/S) scale with effect site drug concentrations during and after brief etomidate infusion. Eighteen American Society of Anesthesiologists status I or II volunteers received etomidate (0.2%) infusion at 5 mg/min until the loss of eyelash reflexes, and spontaneous recovery was allowed. Data for plasma etomidate concentrations, BIS, and OAA/S were collected every minute and analyzed by NONMEM.

Author(s): 
Kaneda, Kotaro
Yamashita, Susumu
Woo, Sukyung
Han, Tae-Hyung
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