Abstract
Monitoring during anaesthesia is crucial for guiding the anaesthetist into anaesthesia and for ensuring that vital parameters are in the safe and physiological range, particularly for haemodynamic and respiratory consequences. What about the ‘depth of anaesthesia’? Vital signs can be modified by a wide range of variables, including drug administration and surgical impact. Similarly, a large number of variables can interfere with the conduction of anaesthesia, such as age, concomitant disease or therapies, physiological parameters and human variability. Several devices for measuring depth of anaesthesia have been recently introduced in clinical practice. Some of these have been tested in adults with promising results. Much more difficult is their application in paediatric patients and the interpretation of data derived from monitoring.
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References
Brosius KK, Bannister CF (2001) Effect of oral midazolam premedication on the awakening concentration of sevoflurane, recovery times and bispectral index in children. Paediatr Anaesth 11:585–590
Park H, Kim YL, Kim CS et al (2007) Changes in bispectral index during recovery from general anesthesia with 2% propofol and remifentanil in children. Pediatr Anesth 17:353–357
Rodriguez RA, Hall LE, Duggan S, Splinter WM (2004) The bispectral index does not correlate with clinical signs of inhalational anesthesia during sevoflurane induction and arousal in children. Can J Anaesth 51:472–480
Davidson AJ, Ironfield CM, Skinner AV, Frawley GP (2006) The effects of caudal local anesthesia blockade on the bispectral index during general anesthesia in children. Paediatr Anaesth 16:828–833
Davidson AJ, Kim MJ, Sangolt GK (2004) Entropy andbispectral index during anaesthesia in children. Anaesth Intensive Care 32:485–493
Klockars JG, Hiller A, Ranta S et al (2006) Spectral entropy as a measure of hypnosis in children. Anesthesiology 104:708–717
Weber F, Hollnberger H, Gruber M et al (2004) Narcotrend depth of anesthesia monitoring in infants and children. Can J Anaesth 51:855–856
Disma N, Lauretta D, Palermo F et al (2007) Level of sedation evaluation with cerebral state index and A-line arx in children undergoing diagnostic procedures. Pediatr Anesth 17:445–447
Myles PS, Leslie K, McNeil J et al (2004) Bispectral index monitoring to prevent awareness during anaesthesia: the B-aware randomised controlled trial. Lancet 363:1757–1763
Gan TJ, Glass PS, Windsor A et al (1997) Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology 87:808–815
Murat I, Constant I (2005) Bispectral index in pediatrics: fashion or a new tool? Pediatr Anesth 15:177–180
Davidson AJ, Huang GH, Czarnecki C et al (2005) Awareness during anesthesia in children: a prospective cohort study. Anesth Analg 100: 653–661
Bannister CF, Brosius KK, Sigl JC et al (2001) The effect of bispectral index monitoring on anesthetic use and recovery in children anesthetized with sevoflurane in nitrous oxide. Anesth Analg 92:877–881
Davidson A (2004) The correlation between bispectral index and airway reflexes with sevoflurane and halothane anaesthesia. Pediatr Anesth 14:241–246
Sadhasivam S, Ganesh A, Robison A et al (2006) Validation of the bispectral index monitor for measuring the depth of sedation in children. Anesth Analg 102:383–388
Powers KS, Nazarian EB, Tapyrik SA et al (2005) Bispectral index as a guide for titration of propofol during procedural sedation among children. Pediatrics 115:1666–1674
Triltsch AE, Nestmann G, Orawa H et al (2005) Bispectral index versus COMFORT score to determine the level of sedation in pediatric intensive care unit patients: a prospective study. Crit Care 9:R9–R17
Crain N, Slonim A, Pollack MM (2002) Assessing sedation in the pediatric intensive care unit by using BIS and the COMFORT scale. Pediatr Crit Care Med 3:11–14
Aneja R, Heard AM, Fletcher JE, Heard CM (2003) Sedation monitoring of children by the bispectral index in the pediatric intensive care unit. Pediatr Crit Care Med 4:60–64
Playfor S, Jenkins I, Boyles C et al (2006) Consensus guidelines on sedation and analgesia in critically ill children. Intensive Care Med 32:1125–1136
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© 2008 Springer-Verlag Italia
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Disma, N., Pellegrino, S., Astuto, M. (2008). Depth of Anaesthesia Monitoring in Children. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-0773-4_17
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DOI: https://doi.org/10.1007/978-88-470-0773-4_17
Publisher Name: Springer, Milano
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