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Comparison of Narcotrend Index, Bispectral Index, spectral and entropy parameters during induction of propofol-remifentanil anaesthesia

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Abstract

Objective

This study investigated the suitability of various electroencephalogram (EEG) parameters to describe anaesthetic drug effects in propofol-remifentanil anaesthesia. The investigated parameters were the Narcotrend® Index (NI), the Bispectral IndexTM (BISTM), and standard spectral and entropy parameters. Additionally, it was investigated whether the effect of a fixed dosage of propofol on the attained depth of hypnosis during induction of anaesthesia is different in male and female patients.

Methods

Standardized inductions of anaesthesia in 10 male and 10 female patients (ASA status I or II, 15–75 years) were analysed. All patients received 4 mg propofol/kg over 6 min followed by 4 mg/kg/h. For analgesia, patients received 0.3 µg/kg/min remifentanil starting 2 min before propofol application. For EEG monitoring, the Narcotrend and the Aspect A-2000 Bispectral Index monitor were used simultaneously. Data from start of propofol injection until 1 min after the end of the induction period (420 s) were used for statistical analysis. EEG parameters were evaluated every 10 s.

Results

The Narcotrend® Index and the Bispectral IndexTM had the highest mean correlations with the calculated propofol effect-site concentration and were able to distinguish stages from the awake state or the near awake state and stages of deep hypnosis. On the Narcotrend scale, more data points are available for levels of anaesthesia with relevance for maintenance of anaesthesia. The BIS values at the first occurrence of burst suppression were significantly higher than the corresponding NI values. During induction of anaesthesia, the same dosages of propofol (per kg body weight) given to men and women did not show different effects on the EEG.

Conclusions

NI and BIS are superior to␣spectral and entropy parameters in describing changes of propofol concentration during induction of propofol-remifentanil anaesthesia.

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Authors and Affiliations

  1. Department of Medical Informatics and Biometry, Klinikum Region Hannover, Hannover, Germany

    Arthur Schultz MD, Ulrich Grouven PhD & Thomas Kneif

  2. Clinic of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany

    Markus Siedenberg &  Barbara Schultz MD

Authors
  1. Arthur Schultz MD
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  2. Markus Siedenberg
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  3. Ulrich Grouven PhD
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  4. Thomas Kneif
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  5. Barbara Schultz MD
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Corresponding author

Correspondence to Arthur Schultz MD.

Additional information

Drs. U. Grouven, A. Schultz and B. Schultz are members of the research group that developed the classification algorithms implemented in the EEG monitor Narcotrend.

Schultz A, Siedenberg M, Grouven U, Kneif T, Schultz B. Comparison of Narcotrend Index, Bispectral Index, spectral and entropy parameters during induction of propofol-remifentanil anaesthesia.

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Schultz, A., Siedenberg, M., Grouven, U. et al. Comparison of Narcotrend Index, Bispectral Index, spectral and entropy parameters during induction of propofol-remifentanil anaesthesia. J Clin Monit Comput 22, 103–111 (2008). https://doi.org/10.1007/s10877-008-9111-6

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  • DOI: https://doi.org/10.1007/s10877-008-9111-6

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