Skip to main content
SpringerLink
Log in

Is It Possible to Monitor the Depth of Anesthesia?

  • Conference paper
Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E.

  • 224 Accesses

Abstract

Awareness during anesthesia is revealed by explicit or implicit memory of intraoperative events. Although large clinical surveys indicate an incidence of explicit awareness of less than 0.3% during anesthesia for general surgery, the possibility of awareness is still a major concern, because patients may develop posttraumatic stress disorder by the experience of being awake during surgery [1]. Successful litigation against the anesthesia professional has been increasing in number as failure to provide adequate anesthesia can be considered a breach of the unwritten contract between patient and anesthetist [2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Heier T, Steen PA (1996) Assessment of anaesthesia depth. Acta Anaesthesiol Scand 40: 1087–1100

    Article  PubMed  CAS  Google Scholar 

  2. Kole TE (1993) Assessing the potential for awareness and learning under anesthesia. AANA journal 61: 571–577

    PubMed  CAS  Google Scholar 

  3. Kissin I (1993) General anesthetic action: an obsolete notion? Anesth Analg 76: 215–218

    Article  PubMed  CAS  Google Scholar 

  4. Thornton C, Gareth Jones J (1993) Evaluating depth of anesthesia: review of methods. International Anesthesiology Clinics 31(4): 67–88

    Article  PubMed  CAS  Google Scholar 

  5. Jordening H, Pedersen T (1991) The incidence of conscious awareness in a general population of anesthetized patients. Anesthesiology 75: A1055

    Article  Google Scholar 

  6. Saucier N, Walts LF, Moreland JR (1983) Patient awareness during nitrous oxide, oxygen and halothane anesthesia. Anesth Analg 62: 239–240

    Article  PubMed  CAS  Google Scholar 

  7. Plourde G (1991) Depth of anaesthesia. Can J Anaesth 38: 270–274

    Article  PubMed  CAS  Google Scholar 

  8. Roizen MF, Horrigan RW, Frazer BM (1981) Anesthetic doses blocking adrenergic (stress) and cardiovascular responses to incision-MAC bar. Anesthesiology 54: 390–398

    Article  PubMed  CAS  Google Scholar 

  9. Zbinden AM, Petersen-Felix S, Thomson DA (1994) Anesthesia depth defined using multiple noxious stimuli during isoforane/oxygen anesthesia. II. Hemodynamic responses. Anesthesiology 80: 261–267

    Article  PubMed  CAS  Google Scholar 

  10. Yasuda N, Weiskopf RB, Cahalan MK et al (1991) Does desflurane modify circulatory responses to stimulations in humans? Anesth Analg 73: 175–179

    Article  PubMed  CAS  Google Scholar 

  11. Stansky DR (1994) Monitoring depth of anesthesia. In: Miller RD (ed) Anesthesia. Churchill Livingstone, New York, pp 1127–1159

    Google Scholar 

  12. Veselis RA, Reinsel RA, Feshchenko VA et al (1994) Impaired memory and behaviour performance with fentanyl at low plasma concentration. Anesth Analg 79: 952–960

    Article  PubMed  CAS  Google Scholar 

  13. Lowenstein E, Philbin DM (1981) Narcotic “anesthesia” in the eighties. Anesthesiology 55: 195–197

    Article  PubMed  CAS  Google Scholar 

  14. Streisand JB, Bailey PL, LeMaire L et al (1993) Fentanyl-induced rigidity and unconsciousness in human volunteers. Anesthesiology 78: 629–634

    Article  PubMed  CAS  Google Scholar 

  15. De Lange S, De Bruijn NP (1983) Alfentanil-oxygen anaesthesia: Plasma concentrations and clinical effects during variable rate continuous infusion for coronary artery surgery. Br J Anaesth 55: 183S–189S

    PubMed  Google Scholar 

  16. Bailey PL, Port JD, McJames S et al (1987) Is fentanyl an anesthetic in the dog? Anesth Analg 66: 542–548

    PubMed  CAS  Google Scholar 

  17. Hug CC, Hall RI, Angert KC et al (1988) Alfentanil plasma concentration v. effect relationship in cardiac surgical patients. Br J Anaesth 61: 435–440

    Article  PubMed  Google Scholar 

  18. Ausems ME, Hug CC, de Lange S (1983) Variable rate infusion of alfentanil as a supplement to nitrous oxide anesthesia for general surgery. Anesth Analg 62: 982–986

    Article  PubMed  CAS  Google Scholar 

  19. Ausems ME, Vuyk J, Hug CC et al (1988) Comparison of a computer-assisted infusion vs. intermittent bolus administration of alfentanil as a supplement to nitrous oxide for lower abdominal surgery. Anesthesiology 68: 851–861

    Article  PubMed  CAS  Google Scholar 

  20. Tunstall ME (1977) Detecting wakefulness during general anaesthesia for caesarean section. Br Med J 274: 1321

    Article  Google Scholar 

  21. King H, Ashley S, Brathwaite D et al (1993) Adequacy of general anesthesia for cesarean section. Anesth Analg 77: 84–88

    Article  PubMed  CAS  Google Scholar 

  22. Russel IF (1985) Does it anesthetize? Anesth Analg 64: 941–942

    Article  Google Scholar 

  23. Russel IF (1985) Comparison of wakefulness with two anaesthetic regimens. Br J Anaesth 58: 965–968

    Article  Google Scholar 

  24. Russel IF (1993) Midazolam-alfentanil: an anaesthetic? An investigation using the isolated forearm technique. Br J Anaesth 70: 42–46

    Article  Google Scholar 

  25. Schultetus RR, Hill CR, Dharamraj CM et al (1986) Wakefulness during cesarean section after induction with ketamine, thiopental, or ketamine and thiopental combined. Anesth Analg 65: 723–728

    Article  PubMed  CAS  Google Scholar 

  26. Bogod DG, Orton JK, Oh TE (1990) Detecting awareness during general anaesthetic caesarean section. Anaesthesia 45: 279–284

    Article  PubMed  CAS  Google Scholar 

  27. Breckenridge JL, Aitkenhead AR (1981) Isolated forearm technique for detection of wakefulness during general anaesthesia. Br J Anaesth 53: 665P–666P

    Google Scholar 

  28. Tunstall ME (1979) The reduction of amnesic wakefulness during caesarean section. Anaesthesia 34: 316–319

    Article  PubMed  CAS  Google Scholar 

  29. Dutton RC, Smith WD, Smith NT (1995) Wakeful response to command indicates memory potential during emergence from general anesthesia. J Clin Monit 11: 35–40

    Article  PubMed  CAS  Google Scholar 

  30. Evans JM, Bithell JF, Vlachonikolis IG (1987) Relationship between lower oesophageal contractility, clinical signs and halothane concentration during general anaesthesia and surgery in man. Br J Anaesth 59: 1346–1355

    Article  PubMed  CAS  Google Scholar 

  31. Raftery S, Enever G, Prys-Roberts C (1991) Oesophageal contractility during total i.v. anaesthesia with and without glycopyrronium. Br J Anaesth 66: 566–571

    Article  PubMed  CAS  Google Scholar 

  32. Sessler DI, Stoen R, Oloffson CI et al (1989) Lower oesophageal contractility predicts movement during skin incision in patients anesthetized with halothane, but not with nitrous oxide and alfentanil. Anesthesiology 70: 42–46

    Article  PubMed  CAS  Google Scholar 

  33. Couture LJ, Edmonds HL (1989) Monitoring responsiveness during anaesthesia. In: Jones JG (ed) Depth of anaesthesia, clinical anaesthesiology. Baillière, Tindall, London, pp 547–558

    Google Scholar 

  34. Clark DL, Rosner BS (1973) Neurophysiologic effects of general anesthetics. I. The electroencephalogram and sensory evoked responses in man. Anesthesiology 38: 564–570

    Article  PubMed  CAS  Google Scholar 

  35. Hung OR, Varvel JR, Shafer SL et al (1992) Thiopental pharmacodynamics. Anesthesiology 77: 237–244

    Article  PubMed  CAS  Google Scholar 

  36. Forrest FC, Tooley MA, Sunders PR et al (1994) Propofol infusion and the suppression of consciousness: the EEG and dose requirements. Br J Anaesth 72: 35–41

    Article  PubMed  CAS  Google Scholar 

  37. Heier T, Steen PA (1996) Assessment of anaesthesia depth. Acta Anaesthesiol Scan 40: 1087–1100

    Article  CAS  Google Scholar 

  38. Sebel PS, Bovill JG, Wauquier A et al (1981) Effects of high-dose fentanyl anesthesia on the electroencephalogram. Anesthesiology 55: 203–211

    Article  PubMed  CAS  Google Scholar 

  39. Levy WJ (1986) Power spectrum correlates of changes in consciousness during anesthetic induction with enflurane. Anesthesiology 64: 688–693

    Article  PubMed  CAS  Google Scholar 

  40. Stanski DR (1994) Monitoring depth of anesthesia. In: Miller RD (ed) Anesthesia. Vol II. Churchill Livingstone, New York, pp 1127–1159

    Google Scholar 

  41. Black S, Mahla ME, Cucchiara RF (1994) Neurologic monitoring. In: Miller RD (ed) Anesthesia. Vol II. Churchill Livingstone, New York, pp 1319–1344

    Google Scholar 

  42. Miyauchi Y, Sakabe T, Maekawa T et al (1985) Responses of EEG, cerebral oxygen consumption and blood flow to peripheral nerve stimulation during thiopentone anaesthesia in dog. Can Anaesth Soc J 32: 491–498

    Article  PubMed  CAS  Google Scholar 

  43. Kochs E, Bischoff P, Pichlmeier U et al (1994) Surgical stimulation induces changes in brain electrical activity during isoflurane-nitrous oxide anesthesia. Anesthesiology 80: 1026–1034

    Article  PubMed  CAS  Google Scholar 

  44. Schwilden H (1989) Use of median EEG frequency and pharmacokinetics in determining depth of anesthesia. In: Jones JG (ed) Depth of anesthesia. Clinical anesthesiology. Ballière Tindall, London, pp 607–620

    Google Scholar 

  45. Long CW, Shah NK, Loughlin C et al (1989) A comparison of EEG determinants of nearawakening from isoflurane and fentanyl anesthesia. Spectral edge, median power frequency and delta ratio. Anesth Analg 69: 169–173

    PubMed  CAS  Google Scholar 

  46. Thornton C (1991) Evoked potentials in anaesthesia. Eur Anaesthesiol 8: 89–107

    CAS  Google Scholar 

  47. Picton TW, Hillyard SA, Krausz HI et al (1974) Human auditory evoked potentials I. Evaluation of components. Electroencephal Clin Neurophysiol 36: 179–190

    Article  CAS  Google Scholar 

  48. Thornton C, Creagh-Barry P, Jordan C et al (1993) Anaesthetic depth and auditory evoked potentials. Acta Anaesthesiol Scand 37: 105–108

    Article  Google Scholar 

  49. Schwender D, Klasing S, Madler C et al (1994) Midlatency auditory evoked potentials and purposeful movements after thiopentone bolus injection. Anaesthesia 49: 99–104

    Article  PubMed  CAS  Google Scholar 

  50. Schwender D, Rimkus T, Haessler R et al (1993) Effect of increasing doses of alfentanil, fentanyl and morphine on mild-latency auditory evoked potentials. Br J Anaesth 71: 622–628

    Article  PubMed  CAS  Google Scholar 

  51. Schwender D, Klasing S, Madler C et al (1993) Mid-latency auditory evoked potentials during ketamine anaesthesia in humans. Br J Anaesth 71: 629–632

    Article  PubMed  CAS  Google Scholar 

  52. Thornton C, Konieczko K, Jones JG et al (1988) Effect of surgical stimulation on the auditory evoked response. Br J Anaesth 60: 372–378

    Article  PubMed  CAS  Google Scholar 

  53. Newton DEF, Thornton C, Konieczko KM et al (1992) Auditory evoked response and awareness: a study in volunteers at sub-MAC concentrations of isoflurane. Br J Anaesth 69: 122–129

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. E. Facco
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Munari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anaesthesiology and Intensive Care, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer-Verlag Italia, Milano

About this paper

Cite this paper

Facco, E., Munari, M., Gallo, F. (1998). Is It Possible to Monitor the Depth of Anesthesia?. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2278-2_65

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2278-2_65

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0007-0

  • Online ISBN: 978-88-470-2278-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation