Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Use of bispectral monitoring in cardiosurgery

Authors: M.M. Rybka, Kh.E. Yusupov, X.E. Diasamidze

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

UDC: 616.12-089]-07

Link: Clinical Physiology of Blood Circulaiton. 2016; 13 (3): 125-130

Quote as: Rybka M.M., Yusupov Kh.E., Diasamidze КЦ. Use of bispectral monitoring in cardiosurgery. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2016; 13 (3): 125-130 (in Russ.).

Received / Accepted:  21.07.2016/21.07.2016

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Abstract

Patients cardiosurgical profile represent a unique group of patients in terms of all possible combinations of high anesthetic risk of perioperative period. Monitoring the depth of anesthesia, based on an assessment of autonomic functions is difficult, since they are absent during cardiopulmonary bypass; assessment of the concentration of volatile agent at the end of exhalation uninformative, as during cardiopulmonary bypass blood flow to the lungs is minimal. Empirical anesthetic dosing regimens based on target- controlled infusion does not take into account the changes in pharmacokinetic and pharmacodynamic drug during cardiopulmonary bypass. In addition, patients of cardiosurgery profile typically can not tolerate standard anesthetic dose calculated without adverse hemodynamic effects. Finally, in some cases anesthesiologists use smaller doses of narcotic analgesics and anesthetics, particularly during the induction due to their potentially negative in case of overdose, the effect on the myocardial contractile function. Considering all the above, it is not surprising that the incidence of unplanned intraoperative wakefulness in cardiac surgical patients is much higher than in the general surgical profile of patients. All of the above actualizes the need for a bispectral monitoring in cardiac surgery.


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