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Relationship between A-line Autoregressive Index, Spectral Entropy and steady state predicted site-effect effective concentrations at 05-50-95 of propofol at different clinical endpoints.
Minerva Anestesiol. 2009 Dec; 75(12):692-7.MA

Abstract

AIM

Target controlled infusion intravenous anesthesia is a growing phenomenon. Nowadays, many anesthesiologists feel the need to monitor depth of anesthesia during total intravenous anesthesia, even though it is not a standard technique worldwide. Spectral Entropy (SE) is a relatively new depth of anesthesia index. The aim of this study was to investigate whether predicted site-effect propofol concentrations, A-line Autoregressive Index (AAI) and SE values are useful for predicting loss of verbal contact (LVC) and loss of consciousness (LOC) during steady-state conditions.

METHODS

Forty-four patients scheduled for elective major abdominal surgery were recruited. All patients were unpremedicated. A target controlled infusion of propofol was administered using Schnider's pharmacokinetic model. The initial propofol infusion provided a site-effect concentration of 1.0 mcg mL-1, and was increased stepwise by 1.0 mcg mL-1 every 4 minutes until the concentration reached 6.0 mcg mL-1. A 4 minute interval was chosen to assure that steady state site-effect concentrations were obtained. AAI, SE and propofol site-effect concentrations were recorded when LVC occurred and also when LOC occurred. Population values for predicted site-effect concentrations at the clinical endpoints were estimated and correlated with AAI and SE values.

RESULTS

In our study for LOC the effect-site concentration to include 90% of patients was 5.85 ?mcg mL-1 (5.70-5.90) and 3.4 mcg mL-1 (3.24-3.60) for LVC. In this study, 90% of patients lost verbal contact at an AAI value of 68 (64.6-71.4) and an SE value of 68.2 (66.2-70.2). LOC occurred in 90% of patients at an AAI value of 39.2 (37.2-41.1) and an SE value of 40.2 (38.1-41.3).

CONCLUSIONS

LOC and LVC occur within a defined range of predicted site-effect concentrations. More emphasis should be given to site-effect concentrations. SE and AAI have similar values at different endpoints and similar correlation with Ceprop. AAI and SE are both useful tools in predicting both LVC and LOC.

Authors+Show Affiliations

Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy. micheleiannuzzi@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19940821

Citation

Iannuzzi, E, et al. "Relationship Between A-line Autoregressive Index, Spectral Entropy and Steady State Predicted Site-effect Effective Concentrations at 05-50-95 of Propofol at Different Clinical Endpoints." Minerva Anestesiologica, vol. 75, no. 12, 2009, pp. 692-7.
Iannuzzi E, Iannuzzi M, Mora B, et al. Relationship between A-line Autoregressive Index, Spectral Entropy and steady state predicted site-effect effective concentrations at 05-50-95 of propofol at different clinical endpoints. Minerva Anestesiol. 2009;75(12):692-7.
Iannuzzi, E., Iannuzzi, M., Mora, B., Sidro, L., Berrino, L., Chiefari, M., & Tufano, R. (2009). Relationship between A-line Autoregressive Index, Spectral Entropy and steady state predicted site-effect effective concentrations at 05-50-95 of propofol at different clinical endpoints. Minerva Anestesiologica, 75(12), 692-7.
Iannuzzi E, et al. Relationship Between A-line Autoregressive Index, Spectral Entropy and Steady State Predicted Site-effect Effective Concentrations at 05-50-95 of Propofol at Different Clinical Endpoints. Minerva Anestesiol. 2009;75(12):692-7. PubMed PMID: 19940821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between A-line Autoregressive Index, Spectral Entropy and steady state predicted site-effect effective concentrations at 05-50-95 of propofol at different clinical endpoints. AU - Iannuzzi,E, AU - Iannuzzi,M, AU - Mora,B, AU - Sidro,L, AU - Berrino,L, AU - Chiefari,M, AU - Tufano,R, PY - 2009/11/27/entrez PY - 2009/11/27/pubmed PY - 2010/4/1/medline SP - 692 EP - 7 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 75 IS - 12 N2 - AIM: Target controlled infusion intravenous anesthesia is a growing phenomenon. Nowadays, many anesthesiologists feel the need to monitor depth of anesthesia during total intravenous anesthesia, even though it is not a standard technique worldwide. Spectral Entropy (SE) is a relatively new depth of anesthesia index. The aim of this study was to investigate whether predicted site-effect propofol concentrations, A-line Autoregressive Index (AAI) and SE values are useful for predicting loss of verbal contact (LVC) and loss of consciousness (LOC) during steady-state conditions. METHODS: Forty-four patients scheduled for elective major abdominal surgery were recruited. All patients were unpremedicated. A target controlled infusion of propofol was administered using Schnider's pharmacokinetic model. The initial propofol infusion provided a site-effect concentration of 1.0 mcg mL-1, and was increased stepwise by 1.0 mcg mL-1 every 4 minutes until the concentration reached 6.0 mcg mL-1. A 4 minute interval was chosen to assure that steady state site-effect concentrations were obtained. AAI, SE and propofol site-effect concentrations were recorded when LVC occurred and also when LOC occurred. Population values for predicted site-effect concentrations at the clinical endpoints were estimated and correlated with AAI and SE values. RESULTS: In our study for LOC the effect-site concentration to include 90% of patients was 5.85 ?mcg mL-1 (5.70-5.90) and 3.4 mcg mL-1 (3.24-3.60) for LVC. In this study, 90% of patients lost verbal contact at an AAI value of 68 (64.6-71.4) and an SE value of 68.2 (66.2-70.2). LOC occurred in 90% of patients at an AAI value of 39.2 (37.2-41.1) and an SE value of 40.2 (38.1-41.3). CONCLUSIONS: LOC and LVC occur within a defined range of predicted site-effect concentrations. More emphasis should be given to site-effect concentrations. SE and AAI have similar values at different endpoints and similar correlation with Ceprop. AAI and SE are both useful tools in predicting both LVC and LOC. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/19940821/Relationship_between_A_line_Autoregressive_Index_Spectral_Entropy_and_steady_state_predicted_site_effect_effective_concentrations_at_05_50_95_of_propofol_at_different_clinical_endpoints_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2009N12A0692 DB - PRIME DP - Unbound Medicine ER -