Comparison of the Measured Values between EEG-entropy and BIS during General Anesthesia and Sedation / 대한마취과학회지

BACKGROUND: The bispectral index (BIS) has been used as a monitor measuring hypnotic level of anesthesia or sedation. Recently EEG-entropy (M-Entropy(TM), S/5(TM) Entropy Module) has been provided and started to use domestically. This study was designed to compare the measured values between EEG-entropy and BIS monitor on general anesthesia and sedation. METHODS: Thirty patients undergoing total hysterectomy were anesthetized with propofol target controlled infusion (TCI), fentanyl, rocuronium and BIS, RE (response entropy), SE (state entropy), and hemodynamic variables were measured at the effect site concentration of 1.5-10.0 microgram/ml (P15-P100). On the other hand, fifteen patients undergoing breast biopsy were sedated with propfol TCI and BIS, RE and SE were measured at 0.9-2.3 microgram/ml (P09-P23). RESULTS: During general anesthesia, SE values were significantly lower than BIS or RE at baseline. But RE alone at P15, RE and SE at P20 were significantly higher than BIS. During sedation, SE values were significantly lower than BIS or RE at baseline-P09 and significantly lower than RE alone at P10-P15, and RE were significantly higher than BIS at P13-P20. After P21, RE and SE values fell abruptly and approached to BIS. CONCLUSIONS: EEG-entropy reflected hypnotic level well equal to BIS during general anesthesia. However, EEG-entropy did less reflected the hypnotic level than BIS during sedation.

The Insertion of a Nasogastric Tube with a Nasopharyngeal Airway / 대한마취과학회지

BACKGROUND: The insertion of a nasogastric tube can be difficult in an anesthetized patient who has a cuffed endotracheal tube in place. The placement of a silastic nasogastric (NG) tube can lead to nasal bleeding or a submucosal dissection in the posterior pharynx. The aim of this study was to determine if the insertion of a nasogastric tube with a nasophryngeal airway can be made easy. METHODS: Sixty patients were randomly assigned to one of two groups; Group 1 and Group 2. For Group 1, a nasogastric tube was inserted first. If this method was not successful with two consecutive attempts, then a nasogastric tube with a nasopharyngeal airway was inserted and if unsuccessful again with two attempts, then Magill forceps were used under laryngoscopy. For Group 2, a nasogastric tube with a nasopharyngeal airway was inserted first. If this method was not successful with two consecutive attempts, then a nasogastric tube was inserted and if unsuccessful again with two attempts, then Magill forceps were used under laryngoscopy. RESULTS: The success rate of the 1st pass in Group 2 was significantly higher than in Group 1 (P < 0.05). The success rate with the 1st intended method in Group 2 was significantly higher than in Group 1 (P < 0.05). The rate of using Magill forceps was not significantly different between the two groups. CONCLUSIONS: The insertion of a nasogastric tube with a nasopharyngeal airway in anesthetized and intubated patients is effective in increasing success rate of insertion. Nasopharyngeal airway traverses the nasopharynx atraumatically and serves as a conduit for the smaller nasogastric tube.