Effects of A-line Autoregression Index (AAI) monitoring on recovery after sevoflurane anesthesia for bariatric surgery.
Monitoring depth of anesthesia may improve anesthetic dosing and postanesthetic recovery in obese patients. Sixty morbidly obese patients undergoing laparoscopic adjustable gastric bandage (LAGB) were randomly assigned to receive anesthesia with sevoflurane titrated by either standard clinical parameters (SCP) (target = baseline hemodynamic parameters ± 20%) or by A-line ARX index (AAI) (target = 20 ± 5). Heart rate, arterial blood pressure, inspiratory and expiratory gas concentrations, and AAI were recorded in all patients at 5-min intervals, but AAI was made available only to the anesthesiologist assigned to AAI-monitored patients. Emergence times in surgery room and recovery times in postanesthesia care unit (PACU) were recorded at 1- and 30-min intervals. Mean intraoperative values of AAI were higher in AAI-monitored than in SCP-monitored patients (22.5 vs 15.0, p = 0.001). Compared to SCP monitoring, AAI monitoring reduced consumption of sevoflurane by 20% (p = 0.014), times to eye opening by 2.4 min (p = 0.001) and to extubation by 2.5 min (p = 0.009) and to achieve SpO(2) 92% in room air by 17 min (p = 0.001). Aldrete scores were higher in AAI- than in SCP-monitored patients at arrival in PACU (p = 0.035), but Aldrete scores ≥ 9 were attained in similar times. AAI monitoring can improve titration of and recovery from sevoflurane for LAGB.
Freo
Ulderico
U
Dipartimento di Farmacologia e Anestesiologia, Università di Padova, Via C. Battisti, 267, 35121, Padova, Italy. ulderico.freo@unipd.it
Carron
Michele
M
Innocente
Federico
F
Foletto
Mirto
M
Nitti
Donato
D
Ori
Carlo
C
D000328:Adult; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D005072:Evoked Potentials, Auditory; D005260:Female; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane
Anesth Analg. 1999 Jul;89(1):243-51
10389813
J Clin Anesth. 1995 Feb;7(1):89-91
7772368
Anesth Analg. 1986 Jun;65(6):575-82
3706798
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):181-9
16634424
Acta Anaesthesiol Scand. 2005 May;49(5):692-7
15836686
Anesth Analg. 2004 Dec;99(6):1848-1853
15562085
Br J Anaesth. 2003 Nov;91(5):638-50
14570784
Anesth Analg. 2008 Dec;107(6):1864-70
19020131
Anesthesiology. 2007 Jan;106(1):33-42
17197843
Br J Anaesth. 2005 Jan;94(1):63-9
15516347
Anaesthesia. 2001 Sep;56(9):888-93
11531678
Can J Neurol Sci. 2008 Mar;35(1):31-40
18380275
Br J Anaesth. 2003 Oct;91(4):502-6
14504150
Anesth Analg. 1997 Sep;85(3):681-6
9296431
Curr Opin Anaesthesiol. 2004 Feb;17(1):21-30
17021525
Anesthesiology. 2003 Oct;99(4):813-8
14508311
J Neurosurg Anesthesiol. 2009 Jul;21(3):207-13
19542997
Br J Anaesth. 2007 Sep;99(3):353-8
17621601
Anesthesiology. 1999 Nov;91(5):1221-31
10551570
Acta Anaesthesiol Scand. 2002 Aug;46(7):882-6
12139546
Br J Anaesth. 2000 Jul;85(1):91-108
10927998
Anesth Analg. 1999 Jan;88(1):213-9
9895095
Anesthesiology. 2004 Apr;100(4):811-7
15087615
Anesth Analg. 2002 Aug;95(2):362-7, table of contents
12145052
J Clin Anesth. 2007 Feb;19(1):3-8
17321919
Anesth Analg. 2003 Jan;96(1):108-11, table of contents
12505934
Eur J Anaesthesiol. 2010 Jun;27(6):501-7
19550338
Anesth Analg. 2004 Mar;98(3):632-41, table of contents
14980911
J Surg Res. 2010 Apr;159(2):622-6
20006346
J Clin Anesth. 2005 Sep;17(6):413-9
16171660
Anesth Analg. 1999 Jul;89(1):209-14
10389806
J Clin Anesth. 2005 Sep;17(6):411-2
16171659
Anesthesiology. 1995 Jun;82(6):1369-78
7793651
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):129-39
16634420
Anesth Analg. 2006 Nov;103(5):1189-95
17056953
CNS Drugs. 2005;19(12):1069-74
16332149
J Clin Anesth. 2005 Mar;17(2):134-45
15809132
Can J Anaesth. 2009 Jun;56(6):449-66
19399574
Acta Anaesthesiol Scand. 2002 May;46(5):495-9
12027841
Anesthesiology. 2009 Nov;111(5):979-87
19809292
Anesth Analg. 1998 Sep;87(3):654-60
9728848
Anesth Analg. 2003 Dec;97(6):1667-1674
14633540
Anesth Analg. 2000 Jan;90(1):168-74
10624999