Premium
Evaluation of the aep EX ™ monitor of hypnotic depth in pediatric patients receiving propofol–remifentanil anesthesia
Author(s) -
Cheung Yuen M.,
Scoones Gail P.,
Hoeks Sanne E.,
Stolker Robert J.,
Weber Frank
Publication year - 2013
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12235
Subject(s) - remifentanil , medicine , propofol , anesthesia , sedation , unconsciousness , receiver operating characteristic , hypnotic , desflurane , area under the curve , target controlled infusion , bispectral index
Summary Background The aep EX Plus monitor (aep EX ) utilizes a mid‐latency auditory evoked potential‐derived index of depth of hypnosis ( D o H ). Objective This observational study evaluates the performance of the aep EX as a D o H monitor for pediatric patients receiving propofol–remifentanil anesthesia. Methods aep EX and BIS values were recorded simultaneously during surgery in three groups of 25 children (aged 1–3, 3–6 and 6–16 years). Propofol was administered by target‐controlled infusion. The U niversity of M ichigan S edation S cale ( UMSS ) was used to clinically assess the D o H during emergence. Prediction probability ( P k ) and receiver operating characteristics ( ROC ) analyses were performed to assess the accuracy of both D o H monitors. Nonlinear regression analysis was used to describe the dose–response relationships for the aep EX , the BIS , and propofol plasma concentrations ( C p ). Results The P k for the aep EX and BIS was 0.36 and 0.21, respectively ( P = 0.010). ROC analysis showed an area under the curve of 0.77 and 0.88 for the aep EX and BIS , respectively ( P = 0.644). At half‐maximal effect ( EC 50 ), C p of 3.13 μg·ml −1 and 3.06 μg·ml −1 were observed for the aep EX and BIS , respectively. The r 2 for the aep EX and BIS was 0.53 and 0.82, respectively. Conclusion The aep EX performs comparable to the BIS in differentiating between consciousness and unconsciousness, while performing inferior to the BIS in terms of distinguishing different levels of sedation and does not correlate well with the C p in children receiving propofol–remifentanil anesthesia.