BJA Advance Access originally published online on April 2, 2004
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British Journal of Anaesthesia, 2004, Vol. 92, No. 6 841-845
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia
Clinical Investigations |
Prediction of depth of sedation and anaesthesia by the NarcotrendTM EEG monitor
Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Zentrum operative Medizin, Oberdürrbacher Strasse 6, D-97080 Würzburg, Germany
*Corresponding author. E-mail: kerstinbauerle{at}gmx.de
Background. The NarcotrendTM (Monitor Technik, Bad Bramstedt, Germany) assesses sedation by automatic classification of EEG signals, using a scale first used for visual evaluation of the EEG. Limited information is available on its value, and only a few studies of the method exist. We set out to study the performance of the NarcotrendTM during propofol sedation.
Methods. In 23 ASA I–II patients, aged 18–65 yr, about to have general anaesthesia, we induced anaesthesia in steps using a target-controlled infusion of propofol. After equilibration for 8 min at each predicted propofol concentration (0.5, 1.0, 2.0, 3.0 and 4.0 µg ml–1), sedation was assessed clinically with the modified Observer’s Assessment of Alertness/Sedation Scale and the NarcotrendTM stage was noted. The prediction performance of the NarcotrendTM was assessed with the prediction probability PK. A PK value of 1.0 means an exact prediction on every occasion, while a PK of 0.5 is no better than a 50:50 chance of being correct.
Results. In 12 women and 11 men (age 42 (SD 11) yr), a total of 138 measurements were made; 129 were analysed and nine were of poor signal quality. The prediction probability for the corresponding level of sedation was PK=0.92 (SE 0.01); for the different target concentrations of propofol it was PK = 0.91 (SE 0.01).
Conclusions. The NarcotrendTM can monitor sedation with propofol. Other sedatives, anaesthetics and opioids should be used to test this monitor.
Br J Anaesth 2004; 92: 841–5
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