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Vol. 66. Issue 2.
Pages 93-103 (February 2019)
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Vol. 66. Issue 2.
Pages 93-103 (February 2019)
Review
DOI: 10.1016/j.redare.2018.06.010
Do we have today a reliable method to detect the moment of loss of consciousness during induction of general anaesthesia?
¿Contamos actualmente con un método fiable para detectar el momento de pérdida de consciencia durante la inducción de la anestesia?
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A.L. Ferreiraa,b,
Corresponding author
ana.leitao.ferreira@gmail.com

Corresponding author.
, C. Nunesb,c, J.G. Mendesa, P. Amorimb
a LAETA/INEGI, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
b Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar do Porto, Porto, Portugal
c Departamento de Ciências e Tecnologia, Universidade Aberta, Porto, Portugal
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Tables (2)
Table 1. Recommended ranges for the different EEG-based indices of the hypnotic component of anaesthesia. Values are dimensionless and range from 0 to 100.
Table 2. Indicative values of the loss of consciousness moment. The values for the loss of consciousness are expressed as “mean (standard deviation)”, “mean (maximum–minimum)”, and “mean” according to the corresponding authors. BIS=bispectral index; SE=state entropy; RE=response entropy; PSI=patient state index; CSI=cerebral state index; IoC=index of consciousness; AAI=AEP index.
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Abstract

This review aims to give an overview of the current state of monitoring depth of anaesthesia and detecting the moment of loss of consciousness, from the first clinical signs involved in anaesthesia to the latest technologies used in this area. Such techniques are extremely important for the development of automatic systems for anaesthesia control, including preventing intraoperative awareness episodes and overdoses. A search in the databases Pubmed and IEEE Xplore was performed using terms such as anaesthetic monitoring, depth of anaesthesia, loss of consciousness, as well as anaesthesia indexes, namely BIS. Despite the several methods capable of monitoring the hypnotic state of anaesthesia, there is still no methodology to accurately detect the moment of loss of consciousness during induction of general anaesthesia.

Keywords:
General anaesthesia
Loss of consciousness
Depth of anaesthesia
Patient monitoring
Resumen

Esta revisión pretende ofrecer una visión general del estado de conocimiento actual sobre la monitorización de la profundidad anestésica y la detección del momento de pérdida de consciencia, desde los primeros signos clínicos implicados en la anestesia hasta las últimas tecnologías utilizadas en esta área. Tales técnicas son extremadamente importantes para el desarrollo de sistemas automáticos de control de la anestesia y para prevenir episodios de percepción intraoperatoria y sobredosis. Realizamos investigaciones en bases de datos (Pubmed, IEEE Xplore) utilizando términos como control anestésico, profundidad de la anestesia, pérdida de consciencia, BIS y cada uno de los índices existentes. A pesar de los diversos métodos capaces de controlar el estado hipnótico de la anestesia, aún no existe una metodología que detecte con precisión el momento de la pérdida de consciencia durante la inducción de la anestesia general.

Palabras clave:
Anestesia general
Pérdida de consciencia
Profundidad de la anestesia
Monitorización del paciente

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