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Objective:To investigate the value of 95% spectral edge frequency (SEF) in identifying the depth of anesthesia in patients with schizophrenia subjected to modified electroconvulsive therapy center.Methods:A total of 195 patients with schizophrenia who received treatment in The Affiliated Kangning Hospital of Wenzhou Medical University in April to December 2020 were included in this study. They were randomly divided into three groups with 65 patients each. Three groups of patients received different doses of anesthesia before undergoing MECT as follows: group A: propofol 1.5 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg; group B: propofol 2.0 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg; group C: propofol 2.5 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg. 95% SEF and bispectral index (BIS) were measured when patients were awake before treatment (T 1), when eyelash reflex disappeared (T 2), at the beginning of electrical stimulation (T 3), at 3 minutes after electrical stimulation (T 4), and when patients were completely awake (T 5) and compared between groups. The incidence of adverse reaction was recorded at 1 day after treatment. Results:At T 1-T 5, 95% SEF in the group A was (28.50 ± 0.87) Hz, (21.49 ± 0.91) Hz, (21.99 ± 0.92) Hz, (28.42 ± 1.29) Hz, (28.40 ± 1.15) Hz respectively, and it was (28.34 ± 0.91) Hz, (18.93 ± 0.86) Hz, (19.05 ± 0.83) Hz, (27.54 ± 0.73) Hz, (28.42 ± 1.21) Hz respectively in group B and (28.26 ± 0.90) Hz, (16.41 ± 0.75) Hz, (16.36 ± 0.75) Hz, (26.58 ± 0.64) Hz, (28.48 ± 1.19) Hz respectively in group C. 95% SEF measured at T 2 ( t = 24.49, 48.60, both P < 0.05), T 3 ( t = 28.47, 54.51, both P < 0.05), and T 4 ( t = 7.61, 15.91, both P < 0.05) in groups B and C were significantly lower than those in group A. 95% SEF measured at T 2 ( t = 24.11, P < 0.05), T 3 ( t = 26.04, P < 0.05) and T 4 ( t = 8.30, P < 0.05) in group C were significantly lower than those in group B. At T 1-T 5, BIS in group A was (94.16 ± 2.07), (55.34 ± 1.93), (56.61 ± 1.84), (76.29 ± 1.94) and (93.84 ± 2.39) respectively, and it was (94.51 ± 2.25), (52.39 ± 1.58), (52.45 ± 1.94), (73.58 ± 2.19), (93.28 ± 2.52) respectively in group B and (93.97 ± 2.16), (50.57 ± 1.96), (51.60 ± 2.03), (69.51 ± 2.12), (93.57 ± 2.66) respectively in group C. BIS values measured at T 2 ( t = 24.49, 48.60, both P < 0.05), T 3 ( t = 28.34, 54.28, both P < 0.05), and T 4 ( t = 7.61, 15.91, both P < 0.05) in groups B and C were significantly lower than those in group A. BIS measured at T 2 ( t = 24.11, P < 0.05), T 3 ( t = 25.93, P < 0.05), and T 4 ( t = 8.30, P < 0.05) in group C were significantly lower than those in group B. Correlation analysis showed that 95% SEF measured at T 2 ( r = 0.65, P < 0.05), T 3 ( r = 0.68, P < 0.05) and T 4 ( r = 0.49, P < 0.05) were positively correlated with BIS measured at corresponding time points. There were no significant differences in duration of electrical stimulation [(61.25 ± 4.32) seconds, (45.19 ± 3.68) seconds, and (27.54 ± 2.54) seconds, F = 1 434.14, P < 0.05], post-onset inhibition index [(87.68 ± 5.82)%, (81.59 ± 5.35)%, (75.27 ± 4.87)%, F = 87.09, P < 0.05], and average seizure energy index [(5 668.38 ± 1 264.01) μV2, (4 555.61 ± 1 058.96) μV2, (3 642.25 ± 792.68) μV2, F = 59.97, P < 0.05] among the three groups. Duration of electrical stimulation ( t = 36.07, 75.71, both P < 0.05), post-onset inhibition index ( t = 9.15, 18.66, both P < 0.05), and average seizure energy index ( t = 8.49, 15.46, both P < 0.05) in groups B and C were significantly lower than those in group A. Duration of electrical stimulation, post-onset inhibition index and average seizure energy index in group C were significantly lower than those in group B ( t = 39.64, 9.50, 6.97, all P < 0.05). BIS was positively correlated with duration of electrical stimulation ( r = 0.68, P < 0.05), post-onset inhibition index ( r = 0.55, P < 0.05) and average seizure energy index ( r = 0.42, P < 0.05). There were no significant differences in the incidences of headache, myalgia, nausea and vomiting among the three groups ( P > 0.05). Conclusion:95% SEF was positively correlated with BIS in patients with schizophrenia. BIS measured at T 2 was positively correlated with effect of modified electroconvulsive therapy center.
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BACKGROUND: An increase in ventilation is known to accelerate the rate of the rise of alveolar concentration of inhalation anesthetics and increase the rate of anesthetic induction. However, it is still debatable whether or not a rise of alveolar isoflurane concentrations by increased minute ventilation (MV) actually increases the depth of anesthesia. METHODS: After anesthetic induction by intravenous thiopental and succinylcholine, and after the bispectral index (BIS) had recovered to 75 after intubation, isoflurane anesthesia was begun (inspired concentration:2 vol.%, respiratory rate:12/min, tidal volume: group I; 8 ml/kg, group II; 12 ml/kg). BIS, spectral edge frequency (SEF), blood pressure, pulse rate were recorded 1 minute before induction, and 1, 2, 3, 4, 5, 7 and 10 minutes after isoflurane anesthesia. End-tidal concentrations of isoflurane and CO2 (ET-iso and -CO2) were recorded at 1, 2, 3, 4, 5, 7 and 10 minutes after isoflurane anesthesia. RESULTS: The increase of ET-iso and the decrease of ET-CO2 were significantly fast in group II. There was no difference in BIS and SEF between the two groups. CONCLUSIONS: Increasing MV induced a rapid rise of alveolar isoflurane concentrations, but changes of BIS and SEF were not affected by increased MV.
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Anesthesia , Anesthetics, Inhalation , Blood Pressure , Heart Rate , Intubation , Isoflurane , Succinylcholine , Thiopental , Tidal Volume , VentilationABSTRACT
Objective To investigate the relationship among the depth of midazolam induced sedation, the plasma midazolam concentration and quantified electroencephalogram(EEG) and determine the appropriate depth of sedation during regional anesthesia Methods Twenty adult ASA I II patients(male 7,female 13)scheduled for thyroid adenoma or cyst operation under cervical plexus blockade were studied The age ranged from 19 57 years [mean (46 4?9 5)yr] and weight from 40 83kg[mean (63 1?10 3)kg] Patients with liver or kidney disorders or habitually taking benzodiazepine were excluded The patients were premedicated with phenobarbital sodium 0 1g Dorsalis pedis artery was cannulated for blood sampling Besides blood pressure, heart rate and SpO 2, quantified EEG (BIS and 95%SEF) were continuously monitored and recorded Level of sedation was assessed using the modified observer's assessment of alertness/sedation (OAA/S) scale The BIS, 95%SEF and plasma midazolam concentration (Cm)were correlated with the OAA/S scores using nonparametric Spearman's rank correlation analysis Results As depth of sedation deepened from an OAA/S score of 4 to 1, BIS value decreased from 91 5?2 6 to 63 1?5 7, 95%SEF from 21 4?2 0 to 15 2?2 9 and plasma midazolam concentration increased from (120 8?55 2)ng/ml to (533 0?139 4)ng/ml BIS, 95%SEF and Cm were all well correlated with the OAA/S score The coefficients of correlation between BIS, 95%SEF, Cm and OAA/S score were 0 952,0 674 and -0 856 respectively Conclusions Cm, BIS and 95% SEF are all well correlated with the depth of midazolam induced sedation and can all be used to monitor the depth of midazolam induced sedation, but BIS is the best among them BIS value 75 82 and OAA/S score 2 3 are the most appropriate level of sedation during regional anesthesia
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0.05), but BIS was markedly lower in group Ⅲ than that in group Ⅰ (P
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The purpose of this study was prospectively to research the relationship between EEG power spectrum and anesthesia depth. Twenty-four patients,aged 20 to 50 years , ASA grade ,scheduled for selected surgical operations, were randomly divided into two groups:enflurane and isoflurane groups. Anesthesia was induced by thiopental 5 mg/kg and atracurium 6-7 mg/kg intravenously and maintained by inhalation anesthetics. After intubation patients were ventilated mechanically to maintain the level of PETCO2 between 4. 27 and 4. 93 kpa. NIBP,HR,SpO2 , ECG and EEG were recorded during anesthesia. According to TOF stimulation test intravenous atracurium 10-15 mg was given intermittently to maintain the ratio of T4/T1 less than 25%. Two channels EEG monitor was applied with the filtration range from 0 to 30 Hz Anesthesia level, adjusted at 0. 5,0. 8, 1. 0, 1. 3, 1. 5, 1. 3, 1. 0, 0.8 or 0. 5 MAC in sequence ,was maintained for 10 to 15 minutes before SEF (spectral edge frequency)and MPF (median power frequency) were recorded. NIBP decreased and HR increased with the inhaled agent concentration (IAC) level rising. The lowest BPs were 13. 1 /9. 33 kPa and 12. 9/8. 1kpa in both groups. There were negative remarkable correlations between either SEF or MPF and IAC in both groups (=- 0. 94 and -0. 82,P
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Objective: To analyse correlation of bispectral index,spectral edge frequency of electroencephalogram with midazolam-induced sedation. Method: 30ASA grade Ⅰ-Ⅱ adult patients, undergoing elective surgery under regional anesthesia were randomly devided into three groups according to intravenous bolus doses of midazolam,i, e. group Ⅰ:0.05mg?kg~(-1),group Ⅱ:0.1mg?kg~(-1),group Ⅲ:0.2mg?kg~(-1). After an intravenous bolus dose of mida zolam was administered,both bispectral index (BIS), 95% spectral edge freguency (SEF) of electroencephalogram were monitored and their correlation with midazolam induced sedation was analysed. Result: Both BIS and 95% SEF-correlated with midazolam-induced sedation significantly (r= 0.86,0.73, P