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Cerebral state index versus bispectral index during propofol–fentanyl–nitrous oxide anesthesia

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Abstract

Purpose

The aim of this study was to compare the cerebral state index (CSI) and bispectral index (BIS) during propofol–fentanyl–nitrous oxide anesthesia.

Methods

Thirty patients scheduled for abdominal surgery, with a mean age of 30–70 years, were enrolled. Anesthesia was induced with propofol and fentanyl and was maintained with propofol, fentanyl, epidural mepivacaine, and nitrous oxide in oxygen. During surgery, the propofol infusion rate was adjusted to try to keep BIS at 40 ± 3 for 10 min and then decreased to keep the BIS at 60 ± 3 for 10 min.

Results

The BIS had a larger value for the time between switching on the apparatus and starting to measure at a signal quality index >75%. The recovery time from disturbance by an electric cautery event was 41 ± 14 s for the BIS and 3 ± 1 s for the CSI (P < 0.05). The absolute values of the BIS and CSI were not significantly different and they showed a good correlation. The bias (mean of the differences, BIS − CSI) was negative at all measurement points, but the limits of agreement and percentage error were small.

Conclusions

The absolute values of the BIS and CSI were not significantly different during propofol–fentanyl–nitrous oxide anesthesia. The start of the measurement was faster with the CSI than with the BIS after switch-on, and measurement was less disturbed by electric cautery with the CSI.

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References

  1. Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology. 1998;89:980–1002.

    Article  CAS  PubMed  Google Scholar 

  2. Jang JSR. ANFIS: adaptive-network-based fuzzy interference system. IEEE Trans Syst Man Cybern. 1993;23:665–85.

    Article  Google Scholar 

  3. Jensen EW, Nebot A. Comparison of, FIR and ANFIS methodologies for the prediction of physiologic parameters in anaesthesiology. In: Proc EUFIT. Aachen. 1998. p. 1809–14.

  4. Anderson RE, Jakobsson JG. Cerebral state monitor, a new small handheld EEG monitor for determining depth of anaesthesia: a clinical comparison with the bispectral index during day-surgery. Eur J Anaesthesiol. 2006;23:208–12.

    Article  CAS  PubMed  Google Scholar 

  5. Anderson RE, Barr G, Jakobsson JG. Cerebral state index during anaesthesia induction: a comparative study with propofol or nitrous oxide. Acta Anaesthesiol Scand. 2005;49:750–3.

    Article  CAS  PubMed  Google Scholar 

  6. Zhong T, Guo QL, Pang YD, Peng LF, Li CL. Comparative evaluation of the cerebral state index and the bispectral index during target-controlled infusion of propofol. Br J Anaesth. 2005;95:798–802.

    Article  CAS  PubMed  Google Scholar 

  7. Jensen EW, Litvan H, Revuelta M, Rodriguez B, Caminal P, Martinez P, Vereecke H, Struys MM. Cerebral state index during propofol anesthesia. A comparison with the bispectral index and the A-line ARX index. Anesthesiology. 2006;105:28–36.

    Article  PubMed  Google Scholar 

  8. Hoymork SC, Hval K, Jensen EW, Raeder J. Can the cerebral state monitor replace the bispectral index in monitoring hypnotic effect during propofol/remifentanil anaesthesia? Acta Anaesthesiol Scand. 2007;51:210–6.

    Article  CAS  PubMed  Google Scholar 

  9. Disma N, Lauretta D, Palermo F, Sapienza D, Ingelmo PM, Astuto M. Level of sedation evaluation with cerebral state index and A-line ARX in children undergoing diagnostic procedures. Pediatr Anaesth. 2007;17:445–51.

    Article  Google Scholar 

  10. Rampil IJ, Kim JS, Lenhardt R, Negishi C, Sessler DI. Bispectral EEG index during nitrous oxide administration. Anesthesiology. 1998;89:671–7.

    Article  CAS  PubMed  Google Scholar 

  11. Barr G, Anderson RE, Owall A, Jakobsson JG. Effects on the bispectral index during medium-high dose fentanyl induction with or without propofol supplement. Acta Anaesthesiol Scand. 2000;44:807–11.

    Article  CAS  PubMed  Google Scholar 

  12. Cortinez LI, Delfino AE, Fuentes R, Munoz HR. Performance of the cerebral state index during increasing levels of propofol anesthesia: a comparison with the bispectral index. Anesth Analg. 2007;104:605–10.

    Article  CAS  PubMed  Google Scholar 

  13. Nasraway SA, Wu EC, Kelleher RM, Yasuda CM, Donnelly AM. How reliable is the bispectral index in critically ill patients? A prospective, comparative, single-blinded observer study. Crit Care Med. 2002;30:1483–7.

    Article  Google Scholar 

  14. Gajraj RJ, Doi M, Mantzaridis H, Kenny GNC. Analysis of the EEG bispectrum, auditory evoked potentials and the EEG power spectrum during repeated transitions from consciousness to unconsciousness. By J Anaesth. 1998;80:46–52.

    CAS  Google Scholar 

  15. Iselin-Chaves IA, Flaishon R, Sebel PS, Howall S, Gan TJ, Sigl J, Ginsberg B, Glass PA. The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the bispectral index. Anesth Analg. 1998;87:949–55.

    Article  CAS  PubMed  Google Scholar 

  16. Hernandez-Gancedo C, Pestana D, Pena N, Royo C, Perez-Chrzanowska H, Criado A. Monitoring sedation in critically ill patients: bispectral index, Ramsay and observer scales. Eur J Anaesthesiol. 2006;23:649–53.

    Article  CAS  PubMed  Google Scholar 

  17. Nishiyama T. Cerebral state index vs bispectral index during sevoflurane-nitrous oxide anaesthesia. Eur J Anaesthesiol. 2009;26:638–42.

    Article  CAS  PubMed  Google Scholar 

  18. Pilge S, Zanner R, Schneider G, Blum J, Kreuzer M, Kochs EF. Time delay of index calculation: analysis of cerebral state, bispectral, and narcotrend indices. Anesthesiology. 2006;104:488–94.

    Article  PubMed  Google Scholar 

  19. Dutton RC, Smith WD, Smith NT. Wakeful response to command indicates memory potential during emergence from general anesthesia. J Clin Monit. 1995;11:35–40.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Kamagaya General Hospital, 929-6 Hatsutomi, Kamagaya, Chiba, 273-0121, Japan

    Tomoki Nishiyama

  2. Department of Critical Care Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kyoko Komatsu

  3. 4-7-3-2015 Minamisenju, Arakawa-ku, Tokyo, 116-0003, Japan

    Tomoki Nishiyama

Authors
  1. Tomoki Nishiyama
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  2. Kyoko Komatsu
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Correspondence to Tomoki Nishiyama.

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Nishiyama, T., Komatsu, K. Cerebral state index versus bispectral index during propofol–fentanyl–nitrous oxide anesthesia. J Anesth 24, 380–385 (2010). https://doi.org/10.1007/s00540-010-0906-5

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  • DOI: https://doi.org/10.1007/s00540-010-0906-5

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