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October 14, 2018
10/14/2018 7:30:00 AM - 10/14/2018 9:30:00 AM
Room North, Hall D, Area C
Comparison of Anesthetic Depth Monitoring for Sedation with Bispectral Index During General Anesthesia
Kyu Nam Kim, M.D.,Ph.D., Dong Won Kim, M.D.,Ph.D.
Hanyang University College of Medicine, Seoul, Korea, Republic of
Disclosures: K. Kim: None. D. Kim: None.
Background: Since modern computer technology and complex statistical modeling techniques were advanced, raw electroencephalogram (EEG) signals have been processed to be transformed as quantitative numbers that indicate the quantitative EEG indexes (qEEGi) used for hypnosis status during anesthesia. A bispectral index (BIS) monitor (Covidien, Boulder. Co, USA) provides clinicians with a qEEGi of the BIS using bispectrum power analysis and used to prevent intraoperative awareness. ADMSTM (Anesthetic Depth Monitor for Sedation, Unimedics CO., LTD., Seoul, Korea) is a newly developed anesthetic depth monitor, which displays the patient’s arousal state as a score of 0-99 points. This monitor provides a uCON of the qEEGi using mono-spectral power analysis and an Adaptive Neural Fuzzy Inference System (ANFIS), identical to the qCON (Quantium Medical, Barcelona, Spain) index. Although many studies have been conducted with BIS monitor, the effect of using ADMS for monitoring anesthetic depth is not well known. Therefore, we performed this study to assess the validity of ADMS monitoring by comparison with BIS monitoring.

Methods: After approval by the Institutional Review Board, 79adult patients scheduled for general anesthesia with sevoflurane were included. Bispectral index (BIS) sensor and Unicon sensor were placed to each patient. Data from each device were collected at awake, loss of consciousness, intubation, incision, every 5 minutes during the operative period and emergence. These data were downloaded from BIS and ADMS monitor. We compared the values using scatter plot and Bland-Altman analyses. The limit of agreement was defined as a bias of ± 1.96 SD in which 95% of the difference between the two sensors were expected to lie. We considered a clinically acceptable level of limit of agreement to be ± 10 BIS units.

Results: Total 1062 data was included in this study. Scatter plot analysis revealed a significant correlation between BIS and ADMS values at all time points (R = 0.931, P < 0.001). Bland-Altman analysis of BIS and ADMS values resulted in a bias of 5.2 with limits of agreement of 7.5 and 4.8 during total anesthesia. Additional values revealed -1.4 bias (3.1, -2.1) during awake, -1.4 bias (5.5, -2.6) at loss of consciousness, 7.4 bias (7.2, 6.9) during maintenance, and 0.2 bias (5.2, -0.9) during emergence.

Conclusions: The present study provided evidence of close correlation between ADMS and BIS monitoring during general anesthesia with sevoflurane. Therefore, we concluded that ADMS monitoring can be the alternative method to assess the depth of anesthesia.

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