Abstract
Intravenous sedation during dental treatment is primarily used in outpatient clinics. Maintenance of a level of sedation sufficient to allow treatment while using the minimum dose possible and to induce faster waking is very important. The benefits of bispectral index monitoring have recently been reported for many applications, and it is expected to prove useful in intravenous sedation during dental treatment. However, because the sensor is attached to the forehead, which may be close to the site of operation, and because no neuromuscular blocking drugs are used, monitoring may be excessively interrupted by artifacts such as electromyographic input. Thus, we investigated the usefulness of bispectral index monitoring for patients under intravenous sedation during dental treatment. The incidence of "good" electroencephalograms, for which the electromyogram was less than 50 dB, signal quality index was more than 25%, and impedance was less than 10 kOhms, was 82.4% +/- 9.2%. These findings suggest that bispectral index monitoring will prove effective for intravenous sedation during dental treatment.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Doi M., Gajraj R. J., Mantzaridis H., Kenny G. N. Relationship between calculated blood concentration of propofol and electrophysiological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential index. Br J Anaesth. 1997 Feb;78(2):180–184. doi: 10.1093/bja/78.2.180. [DOI] [PubMed] [Google Scholar]
- Gan T. J., Glass P. S., Windsor A., Payne F., Rosow C., Sebel P., Manberg P. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology. 1997 Oct;87(4):808–815. doi: 10.1097/00000542-199710000-00014. [DOI] [PubMed] [Google Scholar]
- Glass P. S., Bloom M., Kearse L., Rosow C., Sebel P., Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology. 1997 Apr;86(4):836–847. doi: 10.1097/00000542-199704000-00014. [DOI] [PubMed] [Google Scholar]
- Johansen J. W., Sebel P. S. Development and clinical application of electroencephalographic bispectrum monitoring. Anesthesiology. 2000 Nov;93(5):1336–1344. doi: 10.1097/00000542-200011000-00029. [DOI] [PubMed] [Google Scholar]
- Leslie K., Sessler D. I., Schroeder M., Walters K. Propofol blood concentration and the Bispectral Index predict suppression of learning during propofol/epidural anesthesia in volunteers. Anesth Analg. 1995 Dec;81(6):1269–1274. doi: 10.1097/00000539-199512000-00025. [DOI] [PubMed] [Google Scholar]
- Rampil I. J. A primer for EEG signal processing in anesthesia. Anesthesiology. 1998 Oct;89(4):980–1002. doi: 10.1097/00000542-199810000-00023. [DOI] [PubMed] [Google Scholar]
- Sandler N. A. Additional clinical observations utilizing bispectral analysis. Anesth Prog. 2000 Summer;47(3):84–86. [PMC free article] [PubMed] [Google Scholar]
- Sandler N. A., Hodges J., Sabino M. Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis. J Oral Maxillofac Surg. 2001 Jun;59(6):603–612. doi: 10.1053/joms.2001.23366. [DOI] [PubMed] [Google Scholar]
- Sleigh J. W., Steyn-Ross D. A., Steyn-Ross M. L., Williams M. L., Smith P. Comparison of changes in electroencephalographic measures during induction of general anaesthesia: influence of the gamma frequency band and electromyogram signal. Br J Anaesth. 2001 Jan;86(1):50–58. doi: 10.1093/bja/86.1.50. [DOI] [PubMed] [Google Scholar]
- Song D., Joshi G. P., White P. F. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology. 1997 Oct;87(4):842–848. doi: 10.1097/00000542-199710000-00018. [DOI] [PubMed] [Google Scholar]