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Comparative evaluation of the cerebral state index and the bispectral index during target-controlled infusion of propofol
Authors:Zhong T  Guo Q L  Pang Y D  Peng L F  Li C L
Institution:Department of Anesthesiology and Intensive Care Medicine, Xiangya Hospital, Central Southern University, Changsha 410008, China
Abstract:Background. Cerebral state index (CSI) has recently been introducedas an intra-operative monitor of anaesthetic depth. We comparedthe performance of the CSI to the bispectral index (BIS) inmeasuring depth of anaesthesia during target-controlled infusion(TCI) of propofol. Methods. Twenty Chinese patients undergoing general anaesthesiawere recruited. CSI and BIS, and predicted effect-site concentrationof propofol were recorded. The level of sedation was testedby Modified Observer's Assessment of Alertness/Sedation Scale(MOAAS) every 20 s during stepwise increase (TCI, 0.5 µgml–1) of propofol. The loss of verbal contact (LVC) andloss of response (LOR) were defined by MOAAS values of 2–3and less than 2, respectively. Baseline variability and theprediction probability (PK) were calculated for the BIS andCSI. The values of BIS05 and CSI05, BIS50 and CSI50, BIS95 andCSI95 were calculated at each end-point (LVC and LOR). Results. Baseline variability of CSI was more than that of BIS.Both CSI and BIS showed a high prediction probability for thesteps awake vs LVC, awake vs LOR, and LVC vs LOR, and good correlationswith MOAAS values. Conclusion. Despite larger baseline variation, CSI performedas well as BIS in terms of PK values and correlations with stepchanges in sedation.
Keywords:anaesthesia  depth    anaesthetics i  v    propofol    monitoring  cerebral state index    monitoring  bispectral index
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