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British Journal of Anaesthesia
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British Journal of Anaesthesia
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Bispectral and spectral entropy indices at propofol-induced loss of consciousness in young and elderly patients

Authors: Lysakowski, Christopher; Elia, Nadia; Czarnetzki, Christoph; Dumont, Lionel; Haller, G.; Combescure, Christophe; Tramer, Martin;

Bispectral and spectral entropy indices at propofol-induced loss of consciousness in young and elderly patients

Abstract

Bispectral (BIS) and state/response entropy (SE/RE) indices have been widely used to estimate depth of anaesthesia and sedation. In adults, independent of age, adequate and safe depth of anaesthesia for surgery is usually assumed when these indices are between 40 and 60. Since the EEG is changing with increasing age, we investigated the impact of advanced age on BIS, SE, and RE indices during induction.BIS and SE/RE indices were recorded continuously in elderly (> or =65 yr) and young (< or =40 yr) surgical patients who received propofol until loss of consciousness (LOC) using stepwise increasing effect-site concentrations. LOC was defined as an observer assessment of alertness/sedation score <2, corresponding to the absence of response to mild prodding or shaking.We analysed 35 elderly [average age, 78 yr (range, 67-96)] and 34 young [35 (19-40)] patients. At LOC, all indices were significantly higher in elderly compared with young patients: BIS(LOC), median 70 (range, 58-91) vs 58 (40-70); SE(LOC), 71 (31-88) vs 55.5 (23-79); and RE(LOC), 79 (35-96) vs 59 (25-80) (P<0.001 for all comparisons). With all three monitors, only a minority of elderly patients lost consciousness within a 40-60 index range: two (5.7%) with BIS and RE each, and seven (20%) with SE. In young patients, the respective numbers were 20 (58.8%) for BIS, 13 (38.2%) for SE, and nine (26.5%) for RE.In adults undergoing propofol induction, BIS, SE, and RE indices at LOC are significantly affected by age.

Country
Switzerland
Keywords

Adult, Male, Aging, Consciousness, Entropy, Consciousness/drug effects, 613, Drug Administration Schedule, Young Adult, Monitoring, Intraoperative, 617, Humans, Monitoring, Intraoperative/methods, Infusions, Intravenous, Propofol, Aged, Aged, 80 and over, Anesthetics, Intravenous/administration & dosage/pharmacology, Hemodynamics, Electroencephalography, Signal Processing, Computer-Assisted, Aging/physiology, Hemodynamics/drug effects, Propofol/administration & dosage/pharmacology, Female, Electroencephalography/drug effects/instrumentation/methods, Anesthetics, Intravenous, ddc: ddc:613, ddc: ddc:617

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
60
Top 10%
Top 10%
Top 10%
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