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Question: Regarding the depth of anaesthesia monitoring?
- Auditory evoked potentials are more sensitive than somatosensory evoked potentials.
- The PRST (pressure, rate, sweating and tears) scoring system is most reliable.
- A BIS index of 70 correlates with a good depth of general anaesthesia.
- Entropy deccreases with increasing depth of anaesthesia.
- TOF ratio is a good indicator.
Multiple methods have been devised from time to time to help predict signs of inadequate anaesthesia depth and prevent the possibility of awareness during anaesthesia.
- PRSI (systolic Pressure, heart Rate, Sweating and Tears) method: It relies on clinical signs for predicting a light plane of anaesthesia.
- No proven reduction in the incidence of awareness.
- Beta-blockers, hypothyroidism, autonomic neuropathy can mask the signs of underlying awareness.
- EEG based methods
- EEG (electroencephalogram) analysis: Impractical for routine use (employs 19 electrodes) impractical in clinical practice.
- Bispectral Index:
- An EEG signal derived using three electrodes attached to the patient’s forehead is analyzed by a complex algorithm to generate a dimensionless value between 0 and 100.
- 100= fully awake patient
- 0 = no electric activity in the brain
- 65 to 85 = sedation
- 40 to 65 range correlates with general anaesthesia
- < 40 = burst suppression
- Entropy: The EEG is chaotic in the awakened patient, and entropy is high. As consciousness decreases, so do the level of disorder. Hence entropy decreases during general anaesthesia and can provide quantitative measurement of the depth of anaesthesia. The RE scale ranges from 0 (no brain activity) to 100 (fully awake) and the SE scale ranges from 0 (no brain activity) to 91 (fully awake). The clinically relevant target range for entropy values is 40-60.
- Auditory evoked potentials: The middle latency response of the auditory evoked potential may be useful as an indicator of the hypnotic state during anaesthesia. However, it is difficult to record in some circumstances.
- Forehead galvanometry, the isolated forearm technique and lower oesophageal motility assessment are of historical interest;
Answers:
- true
- false
- false
- true
- false
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Cardiovascular physiology module by targetedaic
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