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High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring
Joint Authors
Bloom, Jamie
Wyler, David
Torjman, Marc C.
Trinh, Tuan
Li, Lucy
Mehta, Amy
Fitchett, Evan
Kastenberg, David
Mahla, Michael
Romo, Victor
Source
Anesthesiology Research and Practice
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-19
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Although anesthesia providers may plan for moderate sedation, the depth of sedation is rarely quantified.
Using processed electroencephalography (EEG) to assess the depth of sedation, this study investigates the incidence of general anesthesia with variable burst suppression in patients receiving propofol for outpatient colonoscopy.
The lessons learned from neuromonitoring can then be used to guide institutional best sedation practice.
Methods.
This was a prospective observational study of 119 outpatients undergoing colonoscopy at Thomas Jefferson University Hospital (TJUH).
Propofol was administered by CRNAs under anesthesiologists’ supervision.
The Patient State Index (PSi™) generated by the Masimo SedLine® Brain Root Function monitor (Masimo Corp., Irvine, CA) was used to assess the depth of sedation.
PSi data correlating to general anesthesia with variable burst suppression were confirmed by neuroelectrophysiologists’ interpretation of unprocessed EEG.
Results.
PSi values of <50 consistent with general anesthesia were attained in 118/119 (99.1%) patients.
Of these patients, 33 (27.7%) attained PSi values <25 consistent with variable burst suppression.
The 118 patients that reached PSi <50 spent a significantly greater percentage (53.1% vs.
42%) of their case at PSi levels <50 compared to PSi levels >50 (p=0.001).
Mean total propofol dose was significantly correlated to patient PSi during periods of PSi <25 (R=0.406, p=0.021).
Conclusion.
Although providers planned for moderate to deep sedation, processed EEG showed patients were under general anesthesia, often with burst suppression.
Anesthesiologists and endoscopists may utilize processed EEG to recognize their institutional practice patterns of procedural sedation with propofol and improve upon it.
American Psychological Association (APA)
Bloom, Jamie& Wyler, David& Torjman, Marc C.& Trinh, Tuan& Li, Lucy& Mehta, Amy…[et al.]. 2020. High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring. Anesthesiology Research and Practice،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1130551
Modern Language Association (MLA)
Bloom, Jamie…[et al.]. High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring. Anesthesiology Research and Practice No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1130551
American Medical Association (AMA)
Bloom, Jamie& Wyler, David& Torjman, Marc C.& Trinh, Tuan& Li, Lucy& Mehta, Amy…[et al.]. High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring. Anesthesiology Research and Practice. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1130551
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1130551