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Auditory evoked potential monitoring with the AAITM-index during spinal surgery: decreased desflurane consumption

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Background:

The auditory evoked potential (AEP) is sensitive to the depth of anesthesia. The A-line monitor is a novel device that processes the amplitude and latency of the AEP during the mid-latency time window to provide a simple numerical index, the AAI™-index. The hypothesis of the present study was that titration of anesthetic depth (desflurane) by means of the AAI™-index could decrease the consumption of the main anesthetic and shorten emergence times. Methods:

Thirty ASA I–II patients scheduled for elective open spine surgery under general anesthesia were randomly allocated to two groups. Group I (n=15), the main anesthetic, desflurane, was titrated with a target AAI™-index of 20±5. Group II (n=15), desflurane was titrated according to routine clinical signs, including heart rate, blood pressure, sweating and tears. No fixed MAC-multiple was sought. The primary study variable was desflurane consumption; and secondary study variables were time to extubation and orientation. Results:

All patients had an uncomplicated course and no patients showed signs of awareness or had any recall postoperatively. AAI™-index guidance reduced desflurane consumption by 29% and improved emergence. Time until extubation and orientation and ability to state name and date of birth was significantly shortened among AAI™-index titrated patients. Conclusion:

Titrating depth of desflurane anesthesia using AAI™-index guidance decreased main anesthetic consumption and improved emergence during spine surgery.
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Keywords: AAI™-index; a-line index; auditory evoked potentials; desflurane; general anesthesia

Document Type: Research Article

Affiliations: 1: Orthopaedics and 2: Department of Cardiothoracic Anesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden 3: Anesthesia, Sabbatsberg Hospital, and

Publication date: 2002-08-01

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