J Clin Monit Comput - Comparison of SNAP? II and BIS Vista indices during normothermic cardiopulmonary bypass under isoflurane anesthesia.

Tópicos

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Resumo

JECTIVE: Processed EEG monitoring during cardiopulmonary bypass (CPB) may help determine loss of consciousness and depth of anesthesia. This study compared the SNAP(?) II and BIS Vista monitors in patients undergoing isoflurane anesthesia with normothermic CPB.METHODS: 40 subjects undergoing CPB with isoflurane anesthesia were enrolled. Subjects were premedicated with 1-2 mg midazolam approximately 5 min prior to acquisition of baseline index values and anesthesia induced with midazolam and fentanyl. Anesthesia was maintained with isoflurane, midazolam, and fentanyl and a cis-atracurium infusion. SNAP(?) II (version 1.2.9 algorithm 1.88) and BIS Vista (application version 3.00 platform version 2.03) indices were recorded at baseline, pre-induction, post-intubation, incision, start of CPB, every 15 min during CPB, end of CPB, and end of case. Agreement between methods was determined using Pearson correlation and the Bland-Altman method with repeated observa- tions.RESULTS: Twenty-four male and 12 female subjects completed the analysis. The correlation between SNAP(?) II and BIS Vista index values was 0.61 (P < 0.005). A linear relationship between the difference in the indices and the average index values was observed following the induction of anesthesia. In awake subjects, the bias between the SNAP(?) II and BIS Vista was 5 (95% CI 3-7). The limits of agreement were 23 (95% CI 19-26) and -13 (95% CI -9--16). During anesthesia, the mean difference on a log scale was 0.11 (95% CI 0.09-0.12). The limits of agreement were 0.43 (95% CI 0.40-0.45) and -0.21 (95% CI -0.18--0.24). The antilog of the mean difference demonstrated that the SNAP(?) II value was 28% (95% CI 24-33%) higher than the BIS Vista value following induction of anesthesia.CONCLUSIONS: The SNAP(?) II monitor demonstrates a consistently positive bias during cardiopulmonary bypass under isoflurane anesthesia compared with the BIS Vista.

Resumo Limpo

jectiv process eeg monitor cardiopulmonari bypass cpb may help determin loss conscious depth anesthesia studi compar snap ii bis vista monitor patient undergo isofluran anesthesia normotherm cpbmethod subject undergo cpb isofluran anesthesia enrol subject premed mg midazolam approxim min prior acquisit baselin index valu anesthesia induc midazolam fentanyl anesthesia maintain isofluran midazolam fentanyl cisatracurium infus snap ii version algorithm bis vista applic version platform version indic record baselin preinduct postintub incis start cpb everi min cpb end cpb end case agreement method determin use pearson correl blandaltman method repeat observa tionsresult twentyfour male femal subject complet analysi correl snap ii bis vista index valu p linear relationship differ indic averag index valu observ follow induct anesthesia awak subject bias snap ii bis vista ci limit agreement ci ci anesthesia mean differ log scale ci limit agreement ci ci antilog mean differ demonstr snap ii valu ci higher bis vista valu follow induct anesthesiaconclus snap ii monitor demonstr consist posit bias cardiopulmonari bypass isofluran anesthesia compar bis vista

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