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Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass
Author(s) -
Tirén C.,
Anderson R. E.,
Barr G.,
Öwall A.,
Jakobsson J. G.
Publication year - 2005
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2004.04063.x
Subject(s) - medicine , propofol , cardiopulmonary bypass , anesthesia , fentanyl , bispectral index , bypass grafting , gold standard (test) , artery , surgery
Summary The lack of a gold standard complicates the evaluation and comparison of anaesthetic depth monitors. This randomised study compares three different depth‐of‐anaesthesia monitors during cardiopulmonary bypass (CPB) at 34 °C with fentanyl/propofol anaesthesia adjusted clinically and blinded to the monitors. Coronary artery bypass grafting patients ( n = 21) were randomly assigned to all three possible paired combinations of three monitors: Bispectral Index (Aspect Medical), AAI TM auditory evoked potential (Danmeter), Entropy TM (Datex‐Ohmeda). Indices were manually recorded every 5 min during CPB. Agreement between paired indices was classified as good, non‐, or disagreement. Anaesthesia was classed as adequate, inadequate, or excessive according to recommended index values. Of the 255 paired indices recorded, 62% showed good agreement, 33% showed non‐agreement, and 5% showed disagreement. Using good agreement between two monitors as a gold standard, a quarter of the measurements indicate inappropriate anaesthetic depth monitoring during CPB with clinically titrated anaesthetic depth.