The Alaris auditory evoked potential monitor as an indicator of seizure inducibility and duration during electroconvulsive therapy: an observational study

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• 作者：Hsing-Hao Huang ; Chun-Yu Wu ; Feng-Sheng Lin ; Yi-Ping Wang…
• 关键词：Auditory evoked potential ; Electroconvulsive therapy ; Seizure inducibility
• 刊名：BMC Anesthesiology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：171 KB
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• 刊物主题：Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
• 出版者：BioMed Central
• ISSN：1471-2253

文摘

Background Precise control of anesthetic depth during electroconvulsive therapy (ECT) is crucial because most intravenous anesthetics have anticonvulsant effects. In this study, we investigated the association between anesthetic depth measured by the Alaris auditory evoked potential index (AAI) and seizure inducibility and seizure duration during ECT. Methods Sixty-four ECTs were evaluated in 12 consecutive patients. General anesthesia was performed with a thiopental-based method. The relationship between the pre-ictal AAI, seizure activity and seizure duration was analyzed, and a possible threshold pre-ictal AAI to induce a seizure duration of at least 25?seconds was calculated. Results Forty-one of the 64 ECT stimuli successfully induced seizure activity that lasted longer than 25?seconds. Pre-ictal AAI was significantly correlated to seizure duration (r--.54, p--.001) and the threshold pre-ictal AAi value was calculated to be 26 (area under curve: 0.76, sensitivity: 70.3% and specificity: 73.9%, p--.001). ECT with a pre-ictal AAI ?26 had a higher incidence of successful seizure activity ( p--.001) and a longer seizure duration (55?±-5 v.s. 21?±-7?seconds, p--.001). Conclusion Maintenance of a pre-ictal AAI value ?26 was associated with an increased incidence of successful seizure activities and a longer seizure duration. This is the first report to investigate Alaris AEP monitoring during ECT.