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New composite index based on midlatency auditory evoked potential and electroencephalographic parameters to optimize correlation with propofol effect site concentration: comparison with bispectral index and solitary used fast extracting auditory evoked potential index

(2005) ANESTHESIOLOGY. 103(3). p.500-507
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Abstract
Background: This study investigates the accuracy of a composite index, the A-Line (R) auditory evoked potentials index version 1.6 (AAI(1.6); Danmeter A/S, Odense, Denmark), as a measure of cerebral anesthetic drug effect in a model for predicting a calculated effect site concentration of propofol (Ce-PROP). The AAI1.6 algorithm extracts information from the midlatency auditory evoked potentials, the spontaneous electroencephalographic activity, and the detection of burst suppression. The former version of this monitor, the A-Line (R) auditory evoked potential index version 1.5, is only based on fast extracted midlatency auditory evoked potential information. Methods: After institutional ethics committee approval (University Hospital, Ghent, Belgium), informed consent was obtained from 13 patients (10 women, 3 men) with an American Society of Anesthesiologists physical status of 1, aged 18-65 yr, who were scheduled to undergo ambulatory gynecologic or urologic surgery. The authors evaluated for Bispectral index, A-Line (R) auditory evoked potential index, version 1.5, AAI(1.6) scaled from 0 to 100 and AAI(1.6) scaled from 0 to 60, the interpatient stability at baseline, the detection of burst suppression, prediction probability, and correlation with Ce-PROP, during a constant infusion of 1% propofol at 300 ml/h. The authors developed pharmacodynamic models relating the predicted Ce-PROP to each measure of cerebral anesthetic drug effect. Results: Bispectral index had the lowest interindividual baseline variability. No significant difference was found with prediction probability analysis for all measures. Comparisons for correlation were performed for all indices. The AAI(1.6) scaled to 60 had a significantly higher correlation with CePROP compared with all other measures. The AAI(1.6) scaled to 100 had a significant higher correlation with Ce-PROP compared with the A-Line (R) auditory evoked potential index version 1.5 (P < 0.05) Conclusions: The authors found that the application of AAI(1.6) has a better correlation with a calculated CepR,,p compared with a solitary fast extracting midlatency auditory evoked potential measure. Whether this improvement in pharmacodynamic tracing is accompanied by an improved clinical performance should be investigated using clinical endpoints.
Keywords
APPROXIMATE ENTROPY, BURST SUPPRESSION, ANESTHETIC DEPTH, EXOGENOUS INPUT, INDUCTION, HYPNOTIC LEVEL, PERFORMANCE, EEG

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Chicago
VEREECKE, HUGO, Pablo Martinez Vasquez, Erik Weber Jensen, Olivier Thas, Rudy Van den Broecke, Eric Mortier, and Michel Struys. 2005. “New Composite Index Based on Midlatency Auditory Evoked Potential and Electroencephalographic Parameters to Optimize Correlation with Propofol Effect Site Concentration: Comparison with Bispectral Index and Solitary Used Fast Extracting Auditory Evoked Potential Index.” Anesthesiology 103 (3): 500–507.
APA
VEREECKE, H., Vasquez, P. M., Jensen, E. W., Thas, O., Van den Broecke, R., Mortier, E., & Struys, M. (2005). New composite index based on midlatency auditory evoked potential and electroencephalographic parameters to optimize correlation with propofol effect site concentration: comparison with bispectral index and solitary used fast extracting auditory evoked potential index. ANESTHESIOLOGY, 103(3), 500–507.
Vancouver
1.
VEREECKE H, Vasquez PM, Jensen EW, Thas O, Van den Broecke R, Mortier E, et al. New composite index based on midlatency auditory evoked potential and electroencephalographic parameters to optimize correlation with propofol effect site concentration: comparison with bispectral index and solitary used fast extracting auditory evoked potential index. ANESTHESIOLOGY. 2005;103(3):500–7.
MLA
VEREECKE, HUGO, Pablo Martinez Vasquez, Erik Weber Jensen, et al. “New Composite Index Based on Midlatency Auditory Evoked Potential and Electroencephalographic Parameters to Optimize Correlation with Propofol Effect Site Concentration: Comparison with Bispectral Index and Solitary Used Fast Extracting Auditory Evoked Potential Index.” ANESTHESIOLOGY 103.3 (2005): 500–507. Print.
@article{324471,
  abstract     = {Background: This study investigates the accuracy of a composite index, the A-Line (R) auditory evoked potentials index version 1.6 (AAI(1.6); Danmeter A/S, Odense, Denmark), as a measure of cerebral anesthetic drug effect in a model for predicting a calculated effect site concentration of propofol (Ce-PROP). The AAI1.6 algorithm extracts information from the midlatency auditory evoked potentials, the spontaneous electroencephalographic activity, and the detection of burst suppression. The former version of this monitor, the A-Line (R) auditory evoked potential index version 1.5, is only based on fast extracted midlatency auditory evoked potential information.
Methods: After institutional ethics committee approval (University Hospital, Ghent, Belgium), informed consent was obtained from 13 patients (10 women, 3 men) with an American Society of Anesthesiologists physical status of 1, aged 18-65 yr, who were scheduled to undergo ambulatory gynecologic or urologic surgery. The authors evaluated for Bispectral index, A-Line (R) auditory evoked potential index, version 1.5, AAI(1.6) scaled from 0 to 100 and AAI(1.6) scaled from 0 to 60, the interpatient stability at baseline, the detection of burst suppression, prediction probability, and correlation with Ce-PROP, during a constant infusion of 1% propofol at 300 ml/h. The authors developed pharmacodynamic models relating the predicted Ce-PROP to each measure of cerebral anesthetic drug effect.
Results: Bispectral index had the lowest interindividual baseline variability. No significant difference was found with prediction probability analysis for all measures. Comparisons for correlation were performed for all indices. The AAI(1.6) scaled to 60 had a significantly higher correlation with CePROP compared with all other measures. The AAI(1.6) scaled to 100 had a significant higher correlation with Ce-PROP compared with the A-Line (R) auditory evoked potential index version 1.5 (P < 0.05)
Conclusions: The authors found that the application of AAI(1.6) has a better correlation with a calculated CepR,,p compared with a solitary fast extracting midlatency auditory evoked potential measure. Whether this improvement in pharmacodynamic tracing is accompanied by an improved clinical performance should be investigated using clinical endpoints.},
  author       = {VEREECKE, HUGO and Vasquez, Pablo Martinez and Jensen, Erik Weber and Thas, Olivier and Van den Broecke, Rudy and Mortier, Eric and Struys, Michel},
  issn         = {0003-3022},
  journal      = {ANESTHESIOLOGY},
  keywords     = {APPROXIMATE ENTROPY,BURST SUPPRESSION,ANESTHETIC DEPTH,EXOGENOUS INPUT,INDUCTION,HYPNOTIC LEVEL,PERFORMANCE,EEG},
  language     = {eng},
  number       = {3},
  pages        = {500--507},
  title        = {New composite index based on midlatency auditory evoked potential and electroencephalographic parameters to optimize correlation with propofol effect site concentration: comparison with bispectral index and solitary used fast extracting auditory evoked potential index},
  url          = {http://dx.doi.org/10.1097/00000542-200509000-00012},
  volume       = {103},
  year         = {2005},
}

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