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      KCI등재 SCOPUS SCIE

      The optimal anesthetic depth for interventional neuroradiology: comparisons between light anesthesia and deep anesthesia

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      https://www.riss.kr/link?id=A104348845

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      다국어 초록 (Multilingual Abstract)

      Background: This study was designed to determine the optimal anesthetic depth for the maintenance and recovery ininterventional neuroradiology. Methods: Eighty-eight patients undergoing interventional neuroradiology were randomly allocated to light a...

      Background: This study was designed to determine the optimal anesthetic depth for the maintenance and recovery ininterventional neuroradiology.
      Methods: Eighty-eight patients undergoing interventional neuroradiology were randomly allocated to light anesthesia(n = 44) or deep anesthesia (n = 44) groups based on the value of the bispectral index (BIS). Anesthesia was inducedwith propofol, alfentanil, and rocuronium and maintained with 1−3% sevoflurane. The concentration of sevoflurane wastitrated to maintain BIS at 40−49 (deep anesthesia group) or 50−59 (light anesthesia group). Phenylephrine was used tomaintain the mean arterial pressure within 20% of preinduction values. Recovery times were recorded.
      Results: The light anesthesia group had a more rapid recovery to spontaneous ventilation, eye opening, extubation, andorientation (4.1 ± 2.3 vs. 5.3 ± 1.8 min, 6.9 ± 3.2 min vs. 9.1 ± 3.2 min, 8.2 ± 3.1 min vs. 10.7 ± 3.3 min, 10.0 ± 3.9 min vs.
      12.9 ± 5.5 min, all P < 0.01) compared to the deep anesthesia group. The use of phenylephrine was significantly increasedin the deep anesthesia group (768 ± 184 vs. 320 ± 82 μg, P < 0.01). More patients moved during the procedure in the lightanesthesia group (6/44 [14%] vs. 0/44 [0%], P = 0.026).
      Conclusions: BIS values between 50 and 59 for interventional neuroradiology were associated with a more rapid recoveryand favorable hemodynamic response, but also with more patient movement. We suggest that maintaining BIS valuesbetween 40 and 49 is preferable for the prevention of patient movement during anesthesia for interventional neuroradiology.

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      참고문헌 (Reference)

      1 Pilge S, "Time delay of index calculation : analysis of cerebral state, bispectral, and narcotrend indices" 104 : 488-494, 2006

      2 최은수, "Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia" 대한마취통증의학회 66 (66): 290-294, 2014

      3 Castagnini HE, "Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recovery than propofol" 51 : 486-491, 2004

      4 Vernon JM, "Prediction of movement using bispectral electroencephalographic analysis during propofol/alfentanil or isoflurane/alfentanil anesthesia" 80 : 780-785, 1995

      5 Leslie K, "Prediction of movement during propofol/nitrous oxide anesthesia. Performance of concentration, electroencephalographic, pupillary, and hemodynamic indicators" 84 : 52-63, 1996

      6 Nakajima R, "Minimum alveolar concentration of sevoflurane in elderly patients" 70 : 273-275, 1993

      7 Iida H, "Isoflurane and sevoflurane induce vasodilation of cerebral vessels via ATP-sensitive K+channel activation" 89 : 954-960, 1998

      8 Molyneux AJ, "International subarachnoid aneurysm trial(ISAT)of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion" 366 : 809-817, 2005

      9 Alshekhlee A, "Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm" 41 : 1471-1476, 2010

      10 Münte S, "General anesthesia for interventional neuroradiology : propofol versus isoflurane" 13 : 186-192, 2001

      1 Pilge S, "Time delay of index calculation : analysis of cerebral state, bispectral, and narcotrend indices" 104 : 488-494, 2006

      2 최은수, "Sevoflurane versus propofol for interventional neuroradiology: a comparison of the maintenance and recovery profiles at comparable depths of anesthesia" 대한마취통증의학회 66 (66): 290-294, 2014

      3 Castagnini HE, "Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recovery than propofol" 51 : 486-491, 2004

      4 Vernon JM, "Prediction of movement using bispectral electroencephalographic analysis during propofol/alfentanil or isoflurane/alfentanil anesthesia" 80 : 780-785, 1995

      5 Leslie K, "Prediction of movement during propofol/nitrous oxide anesthesia. Performance of concentration, electroencephalographic, pupillary, and hemodynamic indicators" 84 : 52-63, 1996

      6 Nakajima R, "Minimum alveolar concentration of sevoflurane in elderly patients" 70 : 273-275, 1993

      7 Iida H, "Isoflurane and sevoflurane induce vasodilation of cerebral vessels via ATP-sensitive K+channel activation" 89 : 954-960, 1998

      8 Molyneux AJ, "International subarachnoid aneurysm trial(ISAT)of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion" 366 : 809-817, 2005

      9 Alshekhlee A, "Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm" 41 : 1471-1476, 2010

      10 Münte S, "General anesthesia for interventional neuroradiology : propofol versus isoflurane" 13 : 186-192, 2001

      11 Katoh T, "Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane" 88 : 642-650, 1998

      12 Ghouri AF, "Electroencephalogram spectral edge frequency, lower esophageal contractility, and autonomic responsiveness during general anesthesia" 9 : 176-185, 1993

      13 Sebel PS, "EEG bispectrum predicts movement during thiopental/isoflurane anesthesia" 11 : 83-91, 1995

      14 Yli-Hankala A, "EEG bispectral index monitoring in sevoflurane or propofol anaesthesia : analysis of direct costs and immediate recovery" 43 : 545-549, 1999

      15 Degoute CS, "EEG bispectral index and hypnotic component of anaesthesia induced by sevoflurane : comparison between children and adults" 86 : 209-212, 2001

      16 Hug CC Jr, "Does opioid “anesthesia” exist?" 73 : 1-4, 1990

      17 Kearse LA Jr, "Bispectral analysis of the electroencephalogram correlates with patient movement to skin incision during propofol/nitrous oxide anesthesia" 81 : 1365-1370, 1994

      18 Glass PS, "Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers" 86 : 836-847, 1997

      19 Monk TG, "Anesthetic management and one-year mortality after noncardiac surgery" 100 : 4-10, 2005

      20 Young WL., "Anesthesia for endovascular neurosurgery and interventional neuroradiology" 25 : 391-412, 2007

      21 Matsuura T, "Advance of age decreases the minimum alveolar concentrations of isoflurane and sevoflurane for maintaining bispectral index below 50" 102 : 331-335, 2009

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