Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.

The objective of this work is to compare the performances of two electroencephalogram based indices for detecting loss of consciousness and loss of response to nociceptive stimulation. Specifically, their behaviour after drug induction and during recovery of consciousness was pointed out. Data was r...

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Autores: Melia U, Gabarron E, Agustí M, Souto N, Pineda P, Fontanet J, Vallverdu M, Jensen EW, Gambus P
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p10425
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10425
Access Level:acceso abierto
Palabra clave:Anesthesia monitor, Clinical indices, Electroencephalography, Nociception
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spelling Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.Melia UGabarron EAgustí MSouto NPineda PFontanet JVallverdu MJensen EWGambus PAnesthesia monitor, Clinical indices, Electroencephalography, NociceptionThe objective of this work is to compare the performances of two electroencephalogram based indices for detecting loss of consciousness and loss of response to nociceptive stimulation. Specifically, their behaviour after drug induction and during recovery of consciousness was pointed out. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. The qCON 2000 monitor (Quantium Medical, Barcelona, Spain) was used to calculate the qCON and qNOX. Loss of response to verbal command and loss of eye-lash reflex were assessed during the transition from awake to anesthetized, defining the state of loss of consciousness. Movement as a response to laryngeal mask (LMA) insertion was interpreted as the response to the nociceptive stimuli. The patients were classified as movers or non-movers. The values of qCON and qNOX were statistically compared. Their fall times and rise times defined at the start and at the end of the surgery were calculated and compared. The results showed that the qCON was able to predict loss of consciousness such as loss of verbal command and eyelash reflex better than qNOX, while the qNOX has a better predictive value for response to noxious stimulation such as LMA insertion. From the analysis of the fall and rise times, it was found that the qNOX fall time (median: 217 s) was significantly longer (p value 0.05) than the qCON fall time (median: 150 s). At the end of the surgery, the qNOX started to increase in median at 45 s before the first annotation related to response to stimuli or recovery of consciousness, while the qCON at 88 s after the first annotation related to response to stimuli or recovery of consciousness (p value 0.05). The indices qCON and qNOX showed different performances in the detection of loss of consciousness and loss of response to stimuli during induction and recovery of consciousness. Furthermore, the qCON showed faster decrease during induction. This behaviour is associated with the hypothesis that the loss of response to stimuli (analgesic effect) might be reached after the loss of consciousness (hypnotic effect). On the contrary, the qNOX showed a faster increase at the end of the surgery, associated with the hypothesis that a higher probability of response to stimuli might be reached before the recovery of consciousness.SPRINGER HEIDELBERG2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10425JOURNAL OF CLINICAL MONITORING AND COMPUTINGISSN: 13871307ISSNe: 15732614reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p104252026-05-27T12:37:41Z
dc.title.none.fl_str_mv Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
title Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
spellingShingle Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
Melia U
Anesthesia monitor, Clinical indices, Electroencephalography, Nociception
title_short Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
title_full Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
title_fullStr Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
title_full_unstemmed Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
title_sort Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
dc.creator.none.fl_str_mv Melia U
Gabarron E
Agustí M
Souto N
Pineda P
Fontanet J
Vallverdu M
Jensen EW
Gambus P
author Melia U
author_facet Melia U
Gabarron E
Agustí M
Souto N
Pineda P
Fontanet J
Vallverdu M
Jensen EW
Gambus P
author_role author
author2 Gabarron E
Agustí M
Souto N
Pineda P
Fontanet J
Vallverdu M
Jensen EW
Gambus P
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anesthesia monitor, Clinical indices, Electroencephalography, Nociception
topic Anesthesia monitor, Clinical indices, Electroencephalography, Nociception
description The objective of this work is to compare the performances of two electroencephalogram based indices for detecting loss of consciousness and loss of response to nociceptive stimulation. Specifically, their behaviour after drug induction and during recovery of consciousness was pointed out. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. The qCON 2000 monitor (Quantium Medical, Barcelona, Spain) was used to calculate the qCON and qNOX. Loss of response to verbal command and loss of eye-lash reflex were assessed during the transition from awake to anesthetized, defining the state of loss of consciousness. Movement as a response to laryngeal mask (LMA) insertion was interpreted as the response to the nociceptive stimuli. The patients were classified as movers or non-movers. The values of qCON and qNOX were statistically compared. Their fall times and rise times defined at the start and at the end of the surgery were calculated and compared. The results showed that the qCON was able to predict loss of consciousness such as loss of verbal command and eyelash reflex better than qNOX, while the qNOX has a better predictive value for response to noxious stimulation such as LMA insertion. From the analysis of the fall and rise times, it was found that the qNOX fall time (median: 217 s) was significantly longer (p value 0.05) than the qCON fall time (median: 150 s). At the end of the surgery, the qNOX started to increase in median at 45 s before the first annotation related to response to stimuli or recovery of consciousness, while the qCON at 88 s after the first annotation related to response to stimuli or recovery of consciousness (p value 0.05). The indices qCON and qNOX showed different performances in the detection of loss of consciousness and loss of response to stimuli during induction and recovery of consciousness. Furthermore, the qCON showed faster decrease during induction. This behaviour is associated with the hypothesis that the loss of response to stimuli (analgesic effect) might be reached after the loss of consciousness (hypnotic effect). On the contrary, the qNOX showed a faster increase at the end of the surgery, associated with the hypothesis that a higher probability of response to stimuli might be reached before the recovery of consciousness.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10425
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10425
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER HEIDELBERG
publisher.none.fl_str_mv SPRINGER HEIDELBERG
dc.source.none.fl_str_mv JOURNAL OF CLINICAL MONITORING AND COMPUTING
ISSN: 13871307
ISSNe: 15732614
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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