• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.567-571
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• 2008

Purpose: The purpose was to assess the usefulness of midazolam in patients undergoing minor oral surgery under conscious sedation. Materials and methods: Bispectral index was examined in 20 patients receiving oral minor surgery with conscious sedation supplemented with local anesthesia. All patients included were ASA I and had no contraindications to the study medications. The patients were escorted to the day surgery operation room where, before the commencement of the sedation and surgical procedures, routine monitoring was applied, including the noninvasive monitoring of arterial blood pressure, arterial oxygen saturation, and 3-lead electrocardiogram (Electrocardiogram). Bispectral index electrodes were applied on the frontotemporal region after cleansing the skin with alcohol. Bispectral index was calculated with the Electrocardiogram monitor (A-2000; Aspect Co.). Midazolam was then titrated (initially 3mg wait 2min and 2mg). Vital sign and Bispectral index checked every 5 minute until the end of the procedure. The results were then compared. Results: The Bispectral index index values throughout the sedation study period alter many level. The index was dropped at 5 minutes after administration, but raised at injection and odontomy procedure. During the operation, mean Bispectral index index was higher than conscious sedation index range($60{\sim}80$). The amnesic effect was shown 17 cases out of 20 cases(85%). Conclusion: Conscious sedation technique using midazolma is a safe and effective method of controlling behavior in oral and maxillofacial surgery.

• 대한수의학회지
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• 제56권3호
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• pp.133-137
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• 2016

Changes in the cardiovascular and bispectral index score were evaluated in dogs subjected to constant rate infusion (CRI) with alfaxalone. Fifteen dogs were assigned to three groups of 5. Groups and doses of alfaxalone were as follows: group 1, 3 mg/kg for induction and 6 mg/kg/h for CRI; group 2, 3 mg/kg for induction and 8 mg/kg/h for CRI; and group 3, 3 mg/kg for induction and 10 mg/kg/h for CRI. CRI was maintained for 1 h. Respiratory rates and blood pressures showed minimal changes; however, mild tachycardia and mild hypoxemia occurred, especially in group 3. There were some disparities between bispectral index score, electromyography and pedal withdrawal reflex test when measuring anesthetic depth. Additional premedications and/or analgesic agents would be helpful to avoid adverse effects of alfaxalone and provide improved cardiopulmonary functions.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2003년도 ICCAS
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• pp.502-507
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• 2003

Toward the development of practical methods for observed data oriented bispectral estimation, an automatic means for determining the smoothing bandwidth of bispectral windows is proposed, that can also provide an associated optimum bispectral estimate of stationary non-Gaussian signals, systematically only from an observed time series datum of finite length. For the conventional non-parametric bispectral estimation, the MSE (mean squared error) of the normalized estimate is reviewed under a certain mixing condition and sufficient data length, mainly from the viewpoint of the inverse relation between its bias and variance with respect to the smoothing bandwidth. Based on the fundamental relation, a systematic method not only for determining the bandwidth, but also for obtaining the optimum bispectral estimate is presented by newly introducing a MSE evaluation index of the estimate only from an observed time series datum of finite length. The effectiveness and fundamental features of the proposed method are illustrated by the basic results of numerical experiments.

• 대한치과마취과학회지
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• 제1권1호
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• pp.21-25
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• 2001

연구배경: 임상적으로 진정법을 시행할 경우 뇌의 상태에 대한 접근은 매우 중요하다. 환자의 뇌에 대한 마취제의 영향을 측정하기 위해 개발된 Bispectral Index (BIS)는 환자의 진정을 방해하지 않고 객관적인 진정정도를 평가할 수 있다. 그러나 이는 항상 진정 깊이의 임상적인 척도와는 일치하지 않는다. 이번 연구에서는 진정법 시행시 환자의 진정 정도를 측정하기 위한 BIS의 유용성을 검증하기 위하여 BIS, 진정점수, 그리고 midazolam의 혈중 농도와의 관계를 연구하였다. 방법: 25명의 건강한 성인 지원자들을 대상으로 무의식을 유도하기 위하여 midazolam 0.08 mg/kg을 정맥으로 주입하였으며 환자의 의식 상태를 진정 회복 시까지 관하였다. BIS와 진정점수는 진정 전과, midazolam 투여 후 10, 20, 30분 간격으로 측정하였다. Midazolam의 혈중 농도는 주입 후 10분 경과 후에 정맥혈 채취 후 HPLC를 이용하여 측정하였다. BIS는 BISTM monitor (Aspect Medical Systems, USA)으로 측정하였으며 또한 진정 정도는 진정 점수로도 평가하였다. 결과: BIS 수치는 진정점수와 유의한 상관관계를 보였다(r = 0.676, p < 0.05). 혈중 midazolam 농도가 감소함에 따라 혈중 농도는 진정점수와 유의한 상관관계를 보였다(r = -0.656). Midazolam 투여 후 10분에서 BIS 수치와 midazolam의 혈중 농도는 유의한 상관관계를 보이지 않았지만(r =0.467) 진정 후 수치는 진정 전 수치와 명확히 구분되었다. 결론: BIS는 환자의 수면상태의 효과적인 척도로 알려져 있으며 진정점수와도 높은 상관관계를 보였다. 그러나 항상 진정 깊이를 나타내는 임상적인 척도와는 일치하지 않았다. 그러므로 진정법 시행동안 BIS 만을 사용하는 것은 더욱 많은 주의가 필요하며 매 주어진 시간마다 다양한 진정 점수 측정방법으로 환자의 의식을 감시하는 것이 추천된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권3호
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• pp.169-172
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• 2003

Purpose : We examined the relationship between BIS, sedation score and plasma midazolam concentration to verify the usefulness of BIS to assess the patient's consciousness during sedation. Patients and Methods : Twenty-five young, healthy adult volunteers participated in this clinical study. Midazolam was administered intravenously up to 0.08 mg/kg to induce unconsciousness and we monitored the patient's physiological and conscious status until complete recovery from sedation. BIS and sedation score were measured before sedation, 10, 20, 30 minutes after midazolam administration. Plasma midazolam concentration was measured 10 minutes after midazolam administration. BIS was measured using A-2000 BISTM monitor (Aspect Medical Systems, USA) and the degree of sedation was evaluated with the sedation score. Results : The BIS score correlated with the sedation score (r = 0.676; P < 0.05). With the decreased plasma midazolam concentration, the correlation was better with sedation score (r = -0.656). Although BIS values did not correlate with calculated plasma concentration of midazolam (r = 0.467) at 10 minutes after midazolam administration, values after sedation were well distinguished from those before sedation. Conclusions : BIS is known for an effective predictor of patient's hypnotic state, and it is correlated with the sedation score. But, it doesn't always coincide with the clinical parameters of depth of sedation. So more attention is needed using BIS only during sedation, and it is advisable that the patient's consciousness is monitored with variable sedation score systems every several minutes.

• 임상간호연구
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• 제18권2호
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• pp.284-295
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• 2012

Purpose: This study was done to clarify effects of bispectral index monitoring sedative administration, compared to MOAA/S (Modified Observer's Assessment of Alertness and Sedation), on conscious sedation, physiological stability and recovery time for patients undergoing endoscopic submucosal dissection. Methods: Participants In this study were patients who underwent endoscopic submucosal dissection because of early gastric cancer. Participants were assigned randomly to an experimental group receiving sedatives based on bispectral index monitoring or to a control group with the MOAA/S instrument. Movements, belching, memory, pain, discomfort, physiological stability (MBP, PR, $SpO_2$), and recovery time were measured during the treatment and recovery. Data were analyzed using Spearman partial correlation coefficient analysis, Mixed model and Wilcoxon rank sum test to determine differences in the parameters. Results: There were no statistically significant differences between the two groups for conscious sedation(movement, belching, memory, pain, or discomfort), physiological stability and recovery time. Conclusion: The results of this study indicate that no differences were found between the two types of monitoring. Thus, use of a bispectral index monitor in clinical practice enabling medical staff to readily assess the conscious sedation of for these patients is expected to be increasingly used as an objective assessment tool for conscious sedation for patient safety.

• Korean Journal of Anesthesiology
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• 제71권6호
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• pp.447-452
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• 2018

Background: Cerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia. Methods: Thirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%. Results: BIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: -0.847, CSI: -0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 ($R^2=0.905$, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% ($R^2=0.559$, 0.540). However, the linearity and slope were decreased in 6% and 8% ($R^2=0.163$, 0.014). Conclusions: CSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2004년도 추계 학술대회
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• pp.9-9
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• 2004

• Clinical Endoscopy
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• 제55권4호
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• pp.518-519
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• 2022

• 대한소아치과학회지
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• 제34권1호
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• pp.91-98
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• 2007

Chloral hydrate (CH)와 Hydroxyzine의 경구 복용을 이용한 진정과 Midazolam을 점막하 주사로 추가 투여한 진정을 Bispectral(BIS) index를 이용하여 두 진정법의 진정 깊이의 차이를 비교 평가하고자 하였다. 모든 환아는 2세-6세 사이의 미국 마취과학회 신체평가 등급 I의 건강한 환아로 진정 요법이 요구되었으며 국소마취와 최소 2개 이상의 치아에 대한 수복 치료가 치료에 포함되었다. 무작위 방법으로 환아를 CH(60mg/kg)와 Hydroxyzine(1mg/kg)을 복용하는 군과 CH(60mg/kg)와 Hydroxyzine(1mg/kg)을 복용하고 점막하 주사로 Midazolam(0.1mg/kg)을 추가 투여하는 군으로 나누었다. 진정 요법 동안 Nitrous Oxide는 두 군 모두 50%로 유지하였다. 환아 행동 평가는 녹화된 비디오 테이프를 보며 매 2분마다 Behavior scale을 이용하여 quiet(Q), crying(C), movement(M), or struggling(S)으로 측정하였다. 두 군의 진정 깊이 비교 평가를 위해 치료가 시작된 시점부터 40분 동안 2분 간격으로 측정한 Pulse rate(PR), Saturation percentage of $O_2(SpO_2)$, behavior scale과 매 2분 단위로 계산된 평균 BIS index를 t-test와 Levene's test를 이용하여 분석하였다. 두 군의 평균 BIS index와 BIS index의 분포는 유의할 만한 차이를 보였다(P<0.001). 점막하 주사로 Midazolam을 추가 투여한 군에서 평균 BIS index가 더 낮은 값을 가지며 표준 편차가 작았다 PR와 $SpO_2$는 두 그룹 모두 정상범위내의 값을 보였다. 점막하 주사를 이용한 Midazolam의 추가 투여는 안전성을 크게 침해하지 않는 범위 내에서 진정 깊이를 깊게 해주며 안정적인 진정을 이루게 함으로써 보다 바람직한 진정을 유도해 줄 수 있는 것으로 사료된다.