The Experts below are selected from a list of 9 Experts worldwide ranked by ideXlab platform
Bernard J Baars - One of the best experts on this subject based on the ideXlab platform.
-
the brain basis of a Consciousness Monitor scientific and medical significance
Consciousness and Cognition, 2001Co-Authors: Bernard J BaarsAbstract:Abstract Surgical patients under anesthesia can wake up unpredictably and be exposed to intense, traumatic pain. Current medical techniques cannot maintain depth of anesthesia at a perfectly stable and safe level; the depth of unConsciousness may change from moment to moment. Without an effective Consciousness Monitor anesthesiologists may not be able to adjust dosages in time to protect patients from pain. An estimated 40,000 to 200,000 midoperative awakenings may occur in the United States annually. E. R. John and coauthors present the scientific basis of a practical “Consciousness Monitor” in two articles. One article is empirical and shows widespread and consistent electrical field changes across subjects and anesthetic agents as soon as Consciousness is lost; these changes reverse when Consciousness is regained afterward. These findings form the basis of a surgical Consciousness Monitor that recently received approval from the U.S. Food and Drug Administration. This may be the first practical application of research on the brain basis of Consciousness. The other John article suggests theoretical explanations at three levels, a neurophysiological account of anesthesia, a neural dynamic account of conscious and unconscious states, and an integrative field theory. Of these, the neurophysiology is the best understood. Neural dynamics is evolving rapidly, with several alternative points of view. The field theory sketched here is the most novel and controversial.
H Litvan - One of the best experts on this subject based on the ideXlab platform.
-
validation of the index of Consciousness during sevoflurane and remifentanil anaesthesia a comparison with the bispectral index and the cerebral state index
BJA: British Journal of Anaesthesia, 2008Co-Authors: M Revuelta, P Paniagua, J M Campos, J A Fernandez, A Martinez, M Jospin, H LitvanAbstract:Abstract Background The purpose of this study was to validate a new level of Consciousness Monitor derived from the EEG, called the index of Consciousness (IoC), by comparing it with the bispectral index (BIS) and the cerebral state index (CSI) during general anaesthesia for cardiac surgery using sevoflurane, remifentanil, and atracurium. Methods After ethical committee approval and written patient consent, data from 35 patients [31 males, four females, age 55 (10) yr] were recorded during general anaesthesia for elective cardiac bypass surgery. All patients were induced with sevoflurane 8%, until the Observer's Assessment of Alertness and Sedation (OAAS) scale level 1 was reached, and then was set at a 1% end-tidal sevoflurane concentration. Subsequently, remifentanil and atracurium were administered, the trachea was intubated, and the procedure continued as usual. To assess accuracy, the prediction probability (Pk) was calculated both during induction and during maintenance. Results The Pk values [mean ( se )] for IoC, BIS, and CSI during induction were 0.90 (0.01), 0.90 (0.01), and 0.88 (0.01), respectively, whereas the corresponding Pk values during maintenance were 0.95 (0.01), 0.94 (0.01), and 0.60 (0.01). Conclusions The three indices performed equally well during the induction phase and were able to predict the level of Consciousness of the patients satisfactorily. During maintenance, the IoC and the BIS showed good agreement with the clinical signs. The CSI was significantly influenced by the administration of atracurium; therefore, the agreement with the OAAS scale during the maintenance phase was significantly less for CSI than for IoC and BIS.
M Revuelta - One of the best experts on this subject based on the ideXlab platform.
-
validation of the index of Consciousness during sevoflurane and remifentanil anaesthesia a comparison with the bispectral index and the cerebral state index
BJA: British Journal of Anaesthesia, 2008Co-Authors: M Revuelta, P Paniagua, J M Campos, J A Fernandez, A Martinez, M Jospin, H LitvanAbstract:Abstract Background The purpose of this study was to validate a new level of Consciousness Monitor derived from the EEG, called the index of Consciousness (IoC), by comparing it with the bispectral index (BIS) and the cerebral state index (CSI) during general anaesthesia for cardiac surgery using sevoflurane, remifentanil, and atracurium. Methods After ethical committee approval and written patient consent, data from 35 patients [31 males, four females, age 55 (10) yr] were recorded during general anaesthesia for elective cardiac bypass surgery. All patients were induced with sevoflurane 8%, until the Observer's Assessment of Alertness and Sedation (OAAS) scale level 1 was reached, and then was set at a 1% end-tidal sevoflurane concentration. Subsequently, remifentanil and atracurium were administered, the trachea was intubated, and the procedure continued as usual. To assess accuracy, the prediction probability (Pk) was calculated both during induction and during maintenance. Results The Pk values [mean ( se )] for IoC, BIS, and CSI during induction were 0.90 (0.01), 0.90 (0.01), and 0.88 (0.01), respectively, whereas the corresponding Pk values during maintenance were 0.95 (0.01), 0.94 (0.01), and 0.60 (0.01). Conclusions The three indices performed equally well during the induction phase and were able to predict the level of Consciousness of the patients satisfactorily. During maintenance, the IoC and the BIS showed good agreement with the clinical signs. The CSI was significantly influenced by the administration of atracurium; therefore, the agreement with the OAAS scale during the maintenance phase was significantly less for CSI than for IoC and BIS.
P Paniagua - One of the best experts on this subject based on the ideXlab platform.
-
validation of the index of Consciousness during sevoflurane and remifentanil anaesthesia a comparison with the bispectral index and the cerebral state index
BJA: British Journal of Anaesthesia, 2008Co-Authors: M Revuelta, P Paniagua, J M Campos, J A Fernandez, A Martinez, M Jospin, H LitvanAbstract:Abstract Background The purpose of this study was to validate a new level of Consciousness Monitor derived from the EEG, called the index of Consciousness (IoC), by comparing it with the bispectral index (BIS) and the cerebral state index (CSI) during general anaesthesia for cardiac surgery using sevoflurane, remifentanil, and atracurium. Methods After ethical committee approval and written patient consent, data from 35 patients [31 males, four females, age 55 (10) yr] were recorded during general anaesthesia for elective cardiac bypass surgery. All patients were induced with sevoflurane 8%, until the Observer's Assessment of Alertness and Sedation (OAAS) scale level 1 was reached, and then was set at a 1% end-tidal sevoflurane concentration. Subsequently, remifentanil and atracurium were administered, the trachea was intubated, and the procedure continued as usual. To assess accuracy, the prediction probability (Pk) was calculated both during induction and during maintenance. Results The Pk values [mean ( se )] for IoC, BIS, and CSI during induction were 0.90 (0.01), 0.90 (0.01), and 0.88 (0.01), respectively, whereas the corresponding Pk values during maintenance were 0.95 (0.01), 0.94 (0.01), and 0.60 (0.01). Conclusions The three indices performed equally well during the induction phase and were able to predict the level of Consciousness of the patients satisfactorily. During maintenance, the IoC and the BIS showed good agreement with the clinical signs. The CSI was significantly influenced by the administration of atracurium; therefore, the agreement with the OAAS scale during the maintenance phase was significantly less for CSI than for IoC and BIS.
J M Campos - One of the best experts on this subject based on the ideXlab platform.
-
validation of the index of Consciousness during sevoflurane and remifentanil anaesthesia a comparison with the bispectral index and the cerebral state index
BJA: British Journal of Anaesthesia, 2008Co-Authors: M Revuelta, P Paniagua, J M Campos, J A Fernandez, A Martinez, M Jospin, H LitvanAbstract:Abstract Background The purpose of this study was to validate a new level of Consciousness Monitor derived from the EEG, called the index of Consciousness (IoC), by comparing it with the bispectral index (BIS) and the cerebral state index (CSI) during general anaesthesia for cardiac surgery using sevoflurane, remifentanil, and atracurium. Methods After ethical committee approval and written patient consent, data from 35 patients [31 males, four females, age 55 (10) yr] were recorded during general anaesthesia for elective cardiac bypass surgery. All patients were induced with sevoflurane 8%, until the Observer's Assessment of Alertness and Sedation (OAAS) scale level 1 was reached, and then was set at a 1% end-tidal sevoflurane concentration. Subsequently, remifentanil and atracurium were administered, the trachea was intubated, and the procedure continued as usual. To assess accuracy, the prediction probability (Pk) was calculated both during induction and during maintenance. Results The Pk values [mean ( se )] for IoC, BIS, and CSI during induction were 0.90 (0.01), 0.90 (0.01), and 0.88 (0.01), respectively, whereas the corresponding Pk values during maintenance were 0.95 (0.01), 0.94 (0.01), and 0.60 (0.01). Conclusions The three indices performed equally well during the induction phase and were able to predict the level of Consciousness of the patients satisfactorily. During maintenance, the IoC and the BIS showed good agreement with the clinical signs. The CSI was significantly influenced by the administration of atracurium; therefore, the agreement with the OAAS scale during the maintenance phase was significantly less for CSI than for IoC and BIS.