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Adaptive Control of Intravenous Anaesthesia by Evoked Potentials

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Control and Automation in Anaesthesia
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Abstract

The state of anaesthesia has proved to be difficult to define, but certain features would be agreed on widely. For example, the principal concern of the surgeon will be to ensure no movement of the patient during the procedure. In contrast, the major concern of the patient is to remain oblivious of any events during surgery and to recover with minimum pain or emesis after the procedure. Considerable distress may be caused to patients who are completely aware and who experience pain during surgery. Reports from patients who suffered this experience provide a dramatic insight into the trauma involved [1, 2].

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References

  1. Tracy J (1993) Awareness in the operating room: a patient’s view. In: Sebel PS, Bonke B, Winograd E (eds) Memory and awareness in anesthesia. Prentice Hall, Englewood Cliffs, NJ, pp 349–353

    Google Scholar 

  2. Moerman N, Bonke B, Oosting J (1993) Awareness and recall during general anesthesia. Facts and feelings. Anesthesiology 79: 454–464

    Google Scholar 

  3. Liu WH, Thorp TA, Graham SG, Aitkenhead AR (1991) Incidence of awareness with recall during general anaesthesia. Anaesthesia 46: 435–437

    Article  PubMed  CAS  Google Scholar 

  4. Osborne GA, Webb RK, Runciman WB (1993) The Australian Incident Monitoring Study. Patient awareness during anaesthesia: an analysis of 2000 incident reports. Anaesth Intensive Care 21: 653–654

    PubMed  CAS  Google Scholar 

  5. Cobcroft MD, Forsdick C (1993) Awareness under anaesthesia: the patients’ point of view. Anaesth Intensive Care 21: 837–843

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Breckenridge JL, Aitkenhead AR (1983) Awareness during anaesthesia: a review. Ann R Coll Surg Engl 65: 93–96

    PubMed  CAS  Google Scholar 

  9. Evans JM, Davies WL (1984) Monitoring anesthesia. In: Sear JW (ed) Clinics in anesthesiology. Saunders, Philidelphia, pp 242–262

    Google Scholar 

  10. Sessler DI, Stoen R, Olofsson CI, Chow F (1989) Lower esophageal contractility predicts movement during skin incision in patients anesthetised with halothane but not with nitrous oxide and alfentanil. Anesthesiology 70: 42–46

    Article  PubMed  CAS  Google Scholar 

  11. Cox PN, White DC (1986) Do oesophageal contractions measure the depth of anaesthesia? Br J Anaesth 58: 131–132

    Google Scholar 

  12. Scott JC, Ponganis KV, Stanski DR (1985) EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology 62: 234–241

    Article  PubMed  CAS  Google Scholar 

  13. Burhrer M, Maitre PO, Ebling WF, Stanski DR (1987) Pharmacological quantitation of midazolam’s CNS drug effect in hypnotic doses. Anesthesiology 67–. A501

    Google Scholar 

  14. Arden JR, Holley FO, Stanski DR (1986) Increased sensitivity to etomidate in the elderly: initial distribution versus altered brain response. Anesthesiology 65: 19–27

    Article  PubMed  CAS  Google Scholar 

  15. Drummond JC, Brann CA, Perkins DE, Wolfe DE (1991) A comparison of median frequency, spectral edge frequency, a frequency band power ratio, total power, and dominance shift in the determination of depth of anaesthesia. Acta Anaesth Scand 35: 693–699

    Article  PubMed  CAS  Google Scholar 

  16. Sebel PS, Rampil I, Cork RC et al (1993) Bispectral analysis for monitoring anesthesia. Anesthesiology 79: A178

    Google Scholar 

  17. Sebel PS, Rampil IJ, Cork RC et al (1994) Bispectral analysis (BIS) for monitoring depth of anesthesia: comparison of anesthetic techniques. Anesthesiology 81: A1488

    Article  Google Scholar 

  18. Kearse LA jr, Manberg P, DeBros F, Chamoun N, Sinai V (1994) Bispectral analysis of the electroencephalogram during induction of anesthesia may predict hemodynamic responses to laryngoscopy and intubation. Electroencephalogr Clin Neurophysiol 90: 194–200

    Article  PubMed  Google Scholar 

  19. Vernon JM, Bowles S, Sebel PS, Chamoun N (1992) EEG bispectrum predicts movement at incision during isoflurane or propofol anesthesia. Anesthesiology 77: A502

    Article  Google Scholar 

  20. Heneghan CP, Thornton C, Navaratnarajah M, Jones JG (1987) Effect of isoflurane on the auditory evoked response in man. Br J Anaesth 59: 277–282

    Article  PubMed  CAS  Google Scholar 

  21. Thornton C, Heneghan CP, James MF, Jones JG (1984) Effects of halothane or enflurane with controlled ventilation on auditory evoked potentials. Br J Anaesth 56: 315–323

    Article  PubMed  CAS  Google Scholar 

  22. Thornton C, Konieczko KM, Knight AB et al (1989) Effect of propofol on the auditory evoked response and oesophageal contractility. Br J Anaesth 63: 411–417

    Article  PubMed  CAS  Google Scholar 

  23. Thornton C, Heneghan CP, Navaratnarajah M, Jones JG (1986) Selective effect of althesin on the auditory evoked response in man. Br J Anaesth 58: 422–427

    Article  PubMed  CAS  Google Scholar 

  24. Thornton C, Heneghan CP, Navaratnarajah M, Bateman PE, Jones JG (1985) Effect of etomidate on the auditory evoked response in man. Br J Anaesth 57: 554–561

    Article  PubMed  CAS  Google Scholar 

  25. Schwender D, Golling W, Klasing S et al (1994) Effects of surgical stimulation on midlatency auditory evoked potentials during general anaesthesia with pro-pofol/fentanyl, isoflurane/fentanyl and flunitrazepam/fentanyl. Anaesthesia 49: 572–578

    Article  PubMed  CAS  Google Scholar 

  26. 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 

  27. Kenny GN, Davies FW, Mantzaridis H (1993) Transition between consciousness and unconsciousness during anesthesia. Anesthesiology 79: A330

    Google Scholar 

  28. Kenny GN, White M (1992) A portable target controlled propofol infusion system. Int J Clin Monit Comput 9: 179–182

    Article  PubMed  CAS  Google Scholar 

  29. Robb HM, Asbury AJ, Gray WM, Linkens DA (1991) Towards a standardized anaesthetic state using enflurane and morphine. Br J Anaesth 66: 358–364

    Article  PubMed  CAS  Google Scholar 

  30. Schwilden H, Stoeckel H, Schüttler J (1989) Closed-loop feedback control of propofol anaesthesia by quantitative EEG analysis in humans. Br J Anaesth 62: 290–296

    Article  PubMed  CAS  Google Scholar 

  31. Schwilden H, Stoeckel H (1990) Effective therapeutic infusions produced by closed-loop feedback control of methohexital administration during total intravenous anesthesia with fentanyl. Anesthesiology 73: 225–229

    Article  PubMed  CAS  Google Scholar 

  32. Schwilden H, Schüttler J, Stoeckel H (1987) Closed-loop feedback control of methohexital anesthesia by quantitative EEG analysis in humans. Anesthesiology 67: 341–347

    Article  PubMed  CAS  Google Scholar 

  33. Kenny GN, McFadzean WA, Mantzaridis H, Fisher AC (1992) Closed-loop control of anesthesia. Anesthesiology 77: A328

    Article  Google Scholar 

  34. Mackenzie AF, Colvin JR, Kenny GN, Bisset WI (1993) Closed-loop control of arterial hypertension following intracranial surgery using sodium nitroprusside. A comparison of intra-operative halothane or isoflurane. Anaesthesia 48: 202–204

    Google Scholar 

  35. Colvin JR, Kenny GN (1989) Automatic control of arterial pressure after cardiac sur¬gery. Evaluation of a microcomputer-based control system using glyceryl trinitrate and sodium nitroprusside. Anaesthesia 44: 37–41

    Google Scholar 

  36. Chaudhri S, Kenny GN (1992) Sedation after cardiac bypass surgery: comparison of propofol and midazolam in the presence of a computerized closed-loop arterial pres¬sure controller. Br J Anaesth 68: 98–99

    Article  PubMed  CAS  Google Scholar 

  37. McMenemin IM, Church J A, Kenny GN (1988) Sedation following cardiac surgery: evaluation of alfentanil and morphine in the presence of a computerized closed-loop arterial pressure controller. Br J Anaesth 61: 669–674

    Article  PubMed  CAS  Google Scholar 

  38. Burns JW, Aitken HA, Bullingham RE, McArdle CS, Kenny GN (1991) Double-blind comparison of the morphine-sparing effect of continuous and intermittent i. m. administration of ketorolac. Br J Anaesth 67: 235–238

    Article  PubMed  CAS  Google Scholar 

  39. McLintock TTC, Aitken HA, Downie C, Kenny GN (1989) Intraoperative suggestions and postoperative analgesia. Br J Anaesth 63: 629–630 P

    Google Scholar 

  40. Kenny GN, McFadzean WA, Mantzaridis H (1993) Propofol requirements during closed-loop anesthesia. Anesthesiology 79: A329

    Google Scholar 

  41. Hutchinson R (1960) Awareness during surgery: a study of its incidence. Br J Anaesth 33: 463–469

    Article  Google Scholar 

  42. Harris TJB, Brice DD, Hetherington RR, Utting JE (1971) Dreaming associated with anaesthesia: the influence of morphine premedication and two volatile adjuvants. Br J Anaesth 43: 172–178

    Article  PubMed  CAS  Google Scholar 

  43. McKenna T, Wilton TN (1973) Awareness during endotracheal intubation. Anaesthesia 28: 599–602

    Article  PubMed  CAS  Google Scholar 

  44. Wilson SL, Vaughan RW, Stephen CR (1975) Awareness, dreams, and halluncinations associated with general anesthesia. Anesth Analgesia 54: 609–617

    Article  CAS  Google Scholar 

  45. Aitkenhead AR (1993) Conscious awareness. In: Sebel PS, Bonke B, Winograd E (eds) Memory and awareness in anesthesia. Prentice Hall, Englewood Cliffs, pp 386–399

    Google Scholar 

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© 1995 Springer-Verlag Berlin Heidelberg

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Kenny, G.N.C., Ray, D.A.A. (1995). Adaptive Control of Intravenous Anaesthesia by Evoked Potentials. In: Schwilden, H., Stoeckel, H. (eds) Control and Automation in Anaesthesia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79573-2_20

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  • DOI: https://doi.org/10.1007/978-3-642-79573-2_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79575-6

  • Online ISBN: 978-3-642-79573-2

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