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Auditory evoked potentials compared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy.
Am J Gastroenterol. 2009 Feb; 104(2):318-25.AJ

Abstract

OBJECTIVES

The purpose of this study was to evaluate and compare Bispectral index (BIS) and A-line auditory evoked potential index (AAI) for monitoring depth of low-dose midazolam and propofol sedation during colonoscopy.

METHODS

A total of 115 consecutive patients (ASA I-IV), receiving low-dose midazolam and propofol sedation for colonoscopy, were evaluated. BIS and AAI levels, Observer's Assessment of Alertness/Sedation (OAA/S) scores, blood pressure, heart rate, oxygen saturation, as well as the presence or absence of eyelash reflex, patient reaction to an external noxious stimulus and to procedure-related pain were recorded every 1-3 min by a single trained observer.

RESULTS

There was a positive correlation between BIS and OAA/S scores (correlation coefficient=0.77) and to a lesser extent AAI and OAA/S scores (correlation coefficient=0.47). BIS and AAI showed significant differences between subsequent levels of sedation (P<0.001). The clustered receiver operating characteristic curve estimate of BIS for the detection of deep sedation was significantly better than that of AAI (P<0.001). Regarding the presence or absence of eyelash reflex and patient reaction to an external noxious stimulus and to procedure-related pain, significant different levels were found for BIS as well as AAI, respectively. Only small changes were observed in hemodynamic variables and oxygen saturation. Overall, our data suggest target BIS levels of slightly above 73 for moderate sedation (defined as OAA/S scores 2 and 3).

CONCLUSIONS

BIS and AAI correlated with the level of sedation. Hemodynamic variables were poor indicators of the hypnotic-anesthetic status of the patient. BIS discriminated best between moderate and deep sedation and could complement clinical observation for guidance of moderate sedation.

Authors+Show Affiliations

12nd Medical Department, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

19190608

Citation

von Delius, Stefan, et al. "Auditory Evoked Potentials Compared With Bispectral Index for Monitoring of Midazolam and Propofol Sedation During Colonoscopy." The American Journal of Gastroenterology, vol. 104, no. 2, 2009, pp. 318-25.
von Delius S, Thies P, Rieder T, et al. Auditory evoked potentials compared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy. Am J Gastroenterol. 2009;104(2):318-25.
von Delius, S., Thies, P., Rieder, T., Wagenpfeil, S., Herberich, E., Karagianni, A., Frimberger, E., Meining, A., Ludwig, L., Ebert, M. P., Schulte-Frohlinde, E., Neu, B., Prinz, C., Schmid, R. M., & Huber, W. (2009). Auditory evoked potentials compared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy. The American Journal of Gastroenterology, 104(2), 318-25. https://doi.org/10.1038/ajg.2008.73
von Delius S, et al. Auditory Evoked Potentials Compared With Bispectral Index for Monitoring of Midazolam and Propofol Sedation During Colonoscopy. Am J Gastroenterol. 2009;104(2):318-25. PubMed PMID: 19190608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Auditory evoked potentials compared with bispectral index for monitoring of midazolam and propofol sedation during colonoscopy. AU - von Delius,Stefan, AU - Thies,Philipp, AU - Rieder,Thomas, AU - Wagenpfeil,Stefan, AU - Herberich,Esther, AU - Karagianni,Artemisia, AU - Frimberger,Eckart, AU - Meining,Alexander, AU - Ludwig,Leopold, AU - Ebert,Matthias Pa, AU - Schulte-Frohlinde,Ewert, AU - Neu,Bruno, AU - Prinz,Christian, AU - Schmid,Roland M, AU - Huber,Wolfgang, Y1 - 2009/01/20/ PY - 2009/2/5/entrez PY - 2009/2/5/pubmed PY - 2009/3/4/medline SP - 318 EP - 25 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 104 IS - 2 N2 - OBJECTIVES: The purpose of this study was to evaluate and compare Bispectral index (BIS) and A-line auditory evoked potential index (AAI) for monitoring depth of low-dose midazolam and propofol sedation during colonoscopy. METHODS: A total of 115 consecutive patients (ASA I-IV), receiving low-dose midazolam and propofol sedation for colonoscopy, were evaluated. BIS and AAI levels, Observer's Assessment of Alertness/Sedation (OAA/S) scores, blood pressure, heart rate, oxygen saturation, as well as the presence or absence of eyelash reflex, patient reaction to an external noxious stimulus and to procedure-related pain were recorded every 1-3 min by a single trained observer. RESULTS: There was a positive correlation between BIS and OAA/S scores (correlation coefficient=0.77) and to a lesser extent AAI and OAA/S scores (correlation coefficient=0.47). BIS and AAI showed significant differences between subsequent levels of sedation (P<0.001). The clustered receiver operating characteristic curve estimate of BIS for the detection of deep sedation was significantly better than that of AAI (P<0.001). Regarding the presence or absence of eyelash reflex and patient reaction to an external noxious stimulus and to procedure-related pain, significant different levels were found for BIS as well as AAI, respectively. Only small changes were observed in hemodynamic variables and oxygen saturation. Overall, our data suggest target BIS levels of slightly above 73 for moderate sedation (defined as OAA/S scores 2 and 3). CONCLUSIONS: BIS and AAI correlated with the level of sedation. Hemodynamic variables were poor indicators of the hypnotic-anesthetic status of the patient. BIS discriminated best between moderate and deep sedation and could complement clinical observation for guidance of moderate sedation. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/19190608/Auditory_evoked_potentials_compared_with_bispectral_index_for_monitoring_of_midazolam_and_propofol_sedation_during_colonoscopy_ L2 - https://Insights.ovid.com/pubmed?pmid=19190608 DB - PRIME DP - Unbound Medicine ER -