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摘要
Introduction: It was to be examined whether EEG monitoring influences the dosing practice of propofol, taking into account age, gender, mode of propofol administration, and opioid choice.
Methods: At 32 study sites, 3 542 patients received total intravenous anaesthesia (TIVA) or target-controlled infusion (TCI). 472 anaesthetics were controlled by clinical parameters (blinded EEG recordings), in 3 070 anaesthetics, the EEG was used for the control of anaesthesia (EEG monitor Narcotrend(R), EEG classification into the stages A (awake) to F (very deep anaesthesia)).
Results: Without EEG monitoring, 5.9% of the anaesthetics were maintained in stage B/C (increased risk of awareness), in 18.7% a burst suppression EEG was found (individual overdosage of general anaesthesia, stage F). 67.2% were conducted in stages D/E, which correspond to deep sleep. EEG monitoring resulted in changes of the propofol dosage from -28.4% to +86.2%. In EEG controlled anaesthetics, women received more propofol than men and had shorter recovery times. Furthermore, with increasing age, a larger reduction of the propofol dosages was found than without EEG, and the difference between the propofol dosages of both genders became smaller with increasing age. Compared to fentanyl, the use of the short-acting opioid remifentanil led to a significant reduction in propofol requirements and recovery times. EEG monitoring caused a significant reduction in propofol consumption with TCI.
Discussion: A considerable number of the anaesthetics which were controlled solely by clinical parameters was too light or too deep. EEG monitoring resulted in significant changes in the dosing strategies at the study sites.
Conclusion: EEG monitoring helps to determine the individual requirements for propofol, which depend on gender, age, and opioid choice.
- 出版日期2010-3
