Narcotrend and Bispectral Index monitor are superior to classic electroencephalographic parameters for the assessment of anesthetic states during propofol-remifentanil anesthesia.
BACKGROUND
A new electroencephalogram monitor, the Narcotrend, was developed to measure anesthetic depth. The authors compared the Narcotrend, the Bispectral Index, and classic electroencephalographic and hemodynamic parameters during anesthesia with propofol and remifentanil.


METHODS
The authors investigated 25 patients undergoing laminectomy at different anesthetic states: awake, steady state anesthesia, first reaction during emergence, and extubation. Narcotrend value; BIS; relative power (percent) in delta, theta, alpha, and beta; median frequency; spectral edge frequency; and hemodynamic parameters were recorded simultaneously. The ability of the classic and processed electroencephalographic and hemodynamic parameters to predict the clinically relevant anesthetic states of awake, steady state anesthesia, first reaction, and extubation was tested using prediction probability.


RESULTS
Only the Narcotrend was able to differentiate between awake versus steady state anesthesia and steady state anesthesia versus first reaction/extubation with a prediction probability value of more than 0.90.


CONCLUSIONS
Modern electroencephalographic parameters, especially Narcotrend, are more reliable indicators for the clinical assessment of anesthetic states than classic parameters.
Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. guschmid@uke.uni-hamburg.de
Gunter N
GN
Schmidt
Petra
P
Bischoff
Thomas
T
Standl
Kai
K
Jensen
Moritz
M
Voigt
Jochen
J
Schulte Am Esch
D000293:Adolescent; D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D004569:Electroencephalography / Q000187:drug effects* / Q000295:instrumentation*; D005260:Female; D005283:Fentanyl; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007796:Laminectomy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D015742:Propofol
D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol