Correlation beween AAI-index and the BIS-index during propofol hypnosis: a clinical study.
OBJECTIVE
To determine the degree of linearity and correlation between the anaesthetic depth indices BIS and AAI over a wide range of hypnotic depth using propofol.


METHODS
20 ASA I patients were studied during propofol induction. Co-induction with 0.05 mg fentanyl and 30 mg propofol iv before initiation of the study. Thereafter repeated doses of propofol 0.5 mg/kg iv. every minute until BIS < 30. Loss of responsiveness to verbal command was determined by repeated loud commands to the patient. BIS (Aspect 2000 XP, BIS algorithm 4.0, system rev. 3.12, Aspect Medical Systems; Natick, MA, U.S.A.) and AAI-index (A-Line Auditory Evoked Potential Monitor, version 1.4, Danmeter A/S; Odense, Denmark) were determined simultaneously (n = 15). BIS alone without acoustical stimulation was studied in a control group (n = 5).


RESULTS
Both indices decreased with increasing dose, and there was a high correlation between the two (r2 = 0.82). The indices showed however different values and while BIS were quite linear, the AAI-index had a more on-offb ehaviour.


CONCLUSIONS
The AAI-index correlates with the BIS-index during propofol hypnosis in the absence of surgical stimulation. Neither the BIS-index, heart rate, nor systemic blood pressure were influenced by the acoustical stimulation from the A-line monitor. Both indices decreased in relation to increasing doses of propofol, but the AAI-index was lower both before becoming unconscious, during transition to unconsciousness, and during the deeper levels of sedation. The AAI-index lacks linearity at both very low and higher levels of propofol sedation with a nearly on-off behaviour for wakefulness vs hypnosis.
Anderson
Russell E
RE
Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden.
Barr
Gunilla
G
Jakobsson
Jan G
JG
D000328:Adult; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D006991:Hypnosis, Anesthetic / Q000145:classification*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D015742:Propofol / Q000494:pharmacology*; D012044:Regression Analysis; D012680:Sensitivity and Specificity
D018686:Anesthetics, Intravenous; D015742:Propofol