Skip Navigation



BJA Advance Access published online on July 6, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem189
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
99/4/547    most recent
aem189v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Ledowski, T.
Right arrow Articles by Schug, S. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ledowski, T.
Right arrow Articles by Schug, S. A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

New parameters of skin conductance compared with bispectral index® monitoring to assess emergence from total intravenous anaesthesia

T. Ledowski1,2,*, J. Preuss1,3, A. Ford1, M. J. Paech1,3, C. McTernan1, R. Kapila1 and S. A. Schug1,3

1 Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street Campus, Perth, WA 6000, Australia
2 Department of Anaesthesia and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany
3 School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia

* Corresponding author: Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street Campus, Perth, WA 6000, Australia. E-mail: thomas.ledowski{at}health.wa.gov.au

Background: Arousal after total i.v. anaesthesia (TIVA) has been reported to be detectable by monitoring the number of fluctuations per second (NFSC), a parameter of skin conductance (SC). However, compared with monitoring of the bispectral index (BIS®), the predictive probability of NFSC was significantly lower. The aim of this study was to determine the value of the two new, not yet published parameters of SC, area under the curve (AUC) methods A and B, for monitoring emergence from TIVA compared with monitoring of NFSC and BIS®.

Methods: Twenty-five patients undergoing surgery were investigated. NFSC, AUC A, AUC B, BIS®, and haemodynamic parameters (mean arterial pressure and heart rate) were recorded simultaneously. The performance of the monitoring devices in distinguishing between the clinical states ‘steady-state anaesthesia’, ‘first clinical reaction’, and ‘extubation’ were compared using the method of prediction probability (Pk) calculation.

Results: BIS® showed the best performance in distinguishing between ‘steady-state anaesthesia’ vs ‘first reaction’ (Pk BIS® 0.95; NFSC 0.73; AUC A 0.54; AUC B 0.62) and ‘steady-state anaesthesia’ vs ‘extubation’ (Pk BIS® 0.99; NFSC 0.73; AUC A 0.71; AUC B 0.67). However, the time from first BIS®>60/SC>0 to a first clinical reaction was significantly shorter for BIS® (median BIS® 180 s; NFSC 780 s; AUC A 750 s; AUC B 690 s; P<0.001).

Conclusions: AUC A and AUC B did not improve accuracy of SC monitoring in patients waking after TIVA.

Keywords: anaesthetics i.v.; monitoring, bispectral index; monitoring, depth of anaesthesia; sympathetic nervous system


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.