Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024
Pausing propofol during neurosurgery to record intraoperative electrocorticography is feasible;10 years of clinical experience.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sun Dongqing, van 't Klooster Maryse A, Ringeling Elise M, Schaft Eline V, van Rijen Peter C, Leijten Frans S S, Demuru Matteo, Robe Pierre A J T, Hoff Reinier G, Zijlmans Maeike, RESPect database group
Аннотация
OBJECTIVE: Intraoperative electrocorticography (ioECoG) during neurosurgery is influenced by anesthetics. In our center we stop the propofol to enable interpretation of ioECoG. We reported our clinical experience and evaluated awareness and hemodynamic changes during the propofol-free periods (PFP).
METHODS: We retrospectively included surgeries with paused propofol administration to record ioECoG (period: 2008-2019). Clinical reports were screened for symptoms of awareness. We compared mean arterial blood pressure (MAP; mmHg) and heart rate (HR;bpm) during PFP to baseline (ten minutes preceding PFP). An increase > 15% was defined as clinically relevant. The association between hemodynamic changes and clinical characteristics was analyzed using logistic regression models.
RESULTS: Propofol administration was paused 742 times in 352 surgeries (mean PFP duration 9 ± 5 min). No signs of awareness were reported. MAP and HR increased > 15% in 54 and six PFPs. Five PFPs showed both MAP and HR increases. Prolonged PFP was associated with having MAP and HR increase during surgery (OR=1.18, 95%CI [1.12-1.26]).
CONCLUSIONS: Signs of inadequate sedation depth were rare. MAP and HR increases were related to the length of PFP.
SIGNIFICANCE: We summarize 10 years of clinical experience with pausing propofol administration during epilepsy surgery to record ioECoG without evidence of awareness.
METHODS: We retrospectively included surgeries with paused propofol administration to record ioECoG (period: 2008-2019). Clinical reports were screened for symptoms of awareness. We compared mean arterial blood pressure (MAP; mmHg) and heart rate (HR;bpm) during PFP to baseline (ten minutes preceding PFP). An increase > 15% was defined as clinically relevant. The association between hemodynamic changes and clinical characteristics was analyzed using logistic regression models.
RESULTS: Propofol administration was paused 742 times in 352 surgeries (mean PFP duration 9 ± 5 min). No signs of awareness were reported. MAP and HR increased > 15% in 54 and six PFPs. Five PFPs showed both MAP and HR increases. Prolonged PFP was associated with having MAP and HR increase during surgery (OR=1.18, 95%CI [1.12-1.26]).
CONCLUSIONS: Signs of inadequate sedation depth were rare. MAP and HR increases were related to the length of PFP.
SIGNIFICANCE: We summarize 10 years of clinical experience with pausing propofol administration during epilepsy surgery to record ioECoG without evidence of awareness.