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Performance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index.
Anesth Analg. 2007 Mar; 104(3):605-10.A&A

Abstract

BACKGROUND

The cerebral state monitor is a new device to measure depth of anesthesia. In this study we compared the cerebral state monitor with the bispectral index (BIS) monitor during propofol anesthesia.

METHODS

Fifteen healthy patients received a continuous infusion of propofol (300 mL/h). The cerebral state index (CSI) and the BIS values were recorded until burst suppression ratio > or =60%. Baseline variability, prediction probability, and agreement analysis between indices were evaluated. Clinical markers of loss of consciousness were also assessed.

RESULTS

Mean awake BIS and CSI values were 95.6 and 91.6, respectively (P = 0.01). BIS and CSI prediction probability values (mean +/- sd) were estimated to be 0.87 +/- 0.08 and 0.86 +/- 0.08, respectively (NS). The CSI tended to stabilize at values of 60-40 when estimated propofol concentrations at the effect site increased from 5 to 8 mug/mL. The BIS stabilized at values of 40-20 when the propofol concentrations at the effect site increased from 7 to 10 mug/mL. The mean BIS-CSI difference was -7.4 with 95% limits of agreement of 22.2 and -36.9. The BIS and CSI correlation with the burst suppression ratio was -0.60 and -0.97, respectively (P < 0.01). Predicted BIS and CSI values for loss of eyelash reflex in 50% and 95% of the patients were different (P < 0.05).

CONCLUSION

The overall performance of both monitors during propofol induction was similar. However, the different dynamic profiles of these monitors indicate that BIS may be a more useful index for evaluating intermediate anesthetic levels, whereas CSI may be better for evaluating deeper anesthetic levels.

Authors+Show Affiliations

Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. licorti@med.puc.clNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17312217

Citation

Cortínez, Luis I., et al. "Performance of the Cerebral State Index During Increasing Levels of Propofol Anesthesia: a Comparison With the Bispectral Index." Anesthesia and Analgesia, vol. 104, no. 3, 2007, pp. 605-10.
Cortínez LI, Delfino AE, Fuentes R, et al. Performance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index. Anesth Analg. 2007;104(3):605-10.
Cortínez, L. I., Delfino, A. E., Fuentes, R., & Muñoz, H. R. (2007). Performance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index. Anesthesia and Analgesia, 104(3), 605-10.
Cortínez LI, et al. Performance of the Cerebral State Index During Increasing Levels of Propofol Anesthesia: a Comparison With the Bispectral Index. Anesth Analg. 2007;104(3):605-10. PubMed PMID: 17312217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Performance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index. AU - Cortínez,Luis I, AU - Delfino,Alejandro E, AU - Fuentes,Ricardo, AU - Muñoz,Hernán R, PY - 2007/2/22/pubmed PY - 2007/3/28/medline PY - 2007/2/22/entrez SP - 605 EP - 10 JF - Anesthesia and analgesia JO - Anesth Analg VL - 104 IS - 3 N2 - BACKGROUND: The cerebral state monitor is a new device to measure depth of anesthesia. In this study we compared the cerebral state monitor with the bispectral index (BIS) monitor during propofol anesthesia. METHODS: Fifteen healthy patients received a continuous infusion of propofol (300 mL/h). The cerebral state index (CSI) and the BIS values were recorded until burst suppression ratio > or =60%. Baseline variability, prediction probability, and agreement analysis between indices were evaluated. Clinical markers of loss of consciousness were also assessed. RESULTS: Mean awake BIS and CSI values were 95.6 and 91.6, respectively (P = 0.01). BIS and CSI prediction probability values (mean +/- sd) were estimated to be 0.87 +/- 0.08 and 0.86 +/- 0.08, respectively (NS). The CSI tended to stabilize at values of 60-40 when estimated propofol concentrations at the effect site increased from 5 to 8 mug/mL. The BIS stabilized at values of 40-20 when the propofol concentrations at the effect site increased from 7 to 10 mug/mL. The mean BIS-CSI difference was -7.4 with 95% limits of agreement of 22.2 and -36.9. The BIS and CSI correlation with the burst suppression ratio was -0.60 and -0.97, respectively (P < 0.01). Predicted BIS and CSI values for loss of eyelash reflex in 50% and 95% of the patients were different (P < 0.05). CONCLUSION: The overall performance of both monitors during propofol induction was similar. However, the different dynamic profiles of these monitors indicate that BIS may be a more useful index for evaluating intermediate anesthetic levels, whereas CSI may be better for evaluating deeper anesthetic levels. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/17312217/Performance_of_the_cerebral_state_index_during_increasing_levels_of_propofol_anesthesia:_a_comparison_with_the_bispectral_index_ L2 - https://doi.org/10.1213/01.ane.0000255152.96354.17 DB - PRIME DP - Unbound Medicine ER -