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Age, minimum alveolar concentration and choice of depth of sedation monitor: examining the paradox of age when using the Narcotrend monitor: A secondary analysis of an observational study
- Source :
- Hight, Darren; Schanderhazi, Cornelia; Huber, Markus; Stüber, Frank; Kaiser, Heiko Andreas (2022). Age, minimum alveolar concentration and choice of depth of sedation monitor: examining the paradox of age when using the Narcotrend monitor: A secondary analysis of an observational study. European journal of anaesthesiology, 39(4), pp. 305-314. Lippincott Williams & Wilkins 10.1097/EJA.0000000000001576
- Publication Year :
- 2021
- Publisher :
- Lippincott Williams & Wilkins, 2021.
-
Abstract
- BACKGROUND With an ageing global population, it is important to individualise titration of anaesthetics according to age and by measuring their effect on the brain. A recent study reported that during general surgery, the given concentration of volatile anaesthetics, expressed as a fraction of the minimum alveolar concentration (MAC fraction), decreases by around only 3% per age-decade, which is less than the 6% expected from age-adjusted MAC. Paradoxically, despite the excessive dosing, Bispectral index (BIS) values also increased. OBJECTIVE We planned to investigate the paradox of age when using the Narcotrend depth of anaesthesia monitor. DESIGN Secondary analyses of a prospective observational study. SETTING Tertiary hospital in Switzerland, recordings took place during 2016 and 2017. PATIENTS One thousand and seventy-two patients undergoing cardiac surgery entered the study, and 909 with noise-free recordings and isoflurane anaesthesia were included in this analysis. INTERVENTION We calculated mean end-tidal MAC fraction and mean index value of the Narcotrend depth of sedation monitor used in the study during the prebypass period. Statistical associations were modelled using linear regression, local weighted regression (LOESS) and a generalised additive model (GAM). MAIN OUTCOME MEASURES Primary endpoints in this study were the change in end-tidal MAC fraction and mean Narcotrend index values, both measured per age-decade. RESULTS We observed a linear decrease in end-tidal MAC fraction of 3.2% per age-decade [95% confidence interval (CI) -3.97% to -2.38%, P
- Subjects :
- Minimum alveolar concentration
medicine.medical_specialty
Isoflurane
business.industry
Sedation
Electroencephalography
610 Medicine & health
Anesthesia, General
Confidence interval
Cardiac surgery
Anesthesiology and Pain Medicine
Child, Preschool
Monitoring, Intraoperative
Bispectral index
Anesthesia
Secondary analysis
Anesthetics, Inhalation
Linear regression
Humans
Medicine
Observational study
medicine.symptom
business
610 Medizin und Gesundheit
Monitoring, Physiologic
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Hight, Darren; Schanderhazi, Cornelia; Huber, Markus; Stüber, Frank; Kaiser, Heiko Andreas (2022). Age, minimum alveolar concentration and choice of depth of sedation monitor: examining the paradox of age when using the Narcotrend monitor: A secondary analysis of an observational study. European journal of anaesthesiology, 39(4), pp. 305-314. Lippincott Williams & Wilkins 10.1097/EJA.0000000000001576 <http://dx.doi.org/10.1097/EJA.0000000000001576>
- Accession number :
- edsair.doi.dedup.....d7f0dfca2ee233b2bae8d18e4ad69f6f
- Full Text :
- https://doi.org/10.48350/157979