Can bispectral index or auditory evoked potential index predict implicit memory during propofol-induced sedation?
BACKGROUND
Some patients still suffer from implicit memory of intraoperative events under adequate depth of anaesthesia. The elimination of implicit memory should be a necessary aim of clinical general anaesthesia. However, implicit memory cannot be tested during anaesthesia yet. We propose bispectral index (BIS) and auditory evoked potential index (AEPI), as predictors of implicit memory during anaesthesia.


METHODS
Thirty-six patients were equally divided into 3 groups according to the Observer's Assessment of Alertness/Sedation Score: A, level 3; B, level 2; and C, level 1. Every patient was given the first auditory stimulus before sedation. Then every patient received the second auditory stimulus after the target level of sedation had been reached. BIS and AEPI were monitored before and after the second auditory stimulus presentation. Four hours later, the inclusion test and exclusion test were performed on the ward using process dissociation procedure and the scores of implicit memory estimated.


RESULTS
In groups A and B but not C, implicit memory estimates were statistically greater than zero (P < 0.05). The implicit memory scores in group A did not differ significantly from those in group B (P > 0.05). Implicit memory scores correlated with BIS and AEPI (P < 0.01). The area under ROC curve is BIS > AEPI. The 95% cutoff points of BIS and AEPI for predicting implicit memory are 47 and 28, respectively.


CONCLUSIONS
Implicit memory does not disappear until the depth of sedation increases to level 1 of OAA/S score. Implicit memory scores correlate well with BIS and AEPI during sedation. BIS is a better index for predicting implicit memory than AEPI during propofol induced sedation.
Wang
Yun
Y
Department of Anaesthesiology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020, China.
Yue
Yun
Y
Sun
Yong-hai
YH
Wu
An-shi
AS
D000293:Adolescent; D000328:Adult; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D008568:Memory / Q000187:drug effects*; D008875:Middle Aged; D015742:Propofol / Q000494:pharmacology*; D012372:ROC Curve
D006993:Hypnotics and Sedatives; D015742:Propofol