References of "BONHOMME, Vincent"
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See detailMécanismes de l'anesthésie générale: apport de l'imagerie fonctionnelle
Boveroux, Pierre ULg; Bonhomme, Vincent ULg; Kirsch, Murielle ULg et al

in Revue Médicale de Liège (2009), 64(Synthèse 2009), 36-41

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See detailManagement of the unstable cervical spine: elective versus emergent cases.
Bonhomme, Vincent ULg; Hans, Pol ULg

in Current Opinion in Anaesthesiology (2009), 22(5), 579-85

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization ... [more ▼]

PURPOSE OF REVIEW: The present review focuses on similarities and discrepancies in the management of emergent and elective unstable cervical spine (C-spine) patients. RECENT FINDINGS: During mobilization, lifting is superior to rolling in limiting spine movements. Before prone position surgery, the transfer of the patient on a rotating table is preferable to rolling. In trauma patients, helical computed tomography (CT) with sagittal reconstruction is the first choice for clearing the C-spine. In those patients, airway compromise may be related to hidden cervical edema or hematoma. Several devices can be of help in performing safe tracheal intubation in patients with limited neck movements, but awake fiberoptic intubation remains the safest procedure. The muscle relaxant antagonist sugammadex can improve safety for rapid sequence induction. It can rapidly reverse profound steroid-based neuromuscular blockade and allows avoidance of succinylcholine in this indication. Propofol anesthesia better prevents coughing upon emergence than inhaled anesthesia. Neuroprotection in cord-damaged patients is disappointing, and the controversy on the efficacy of high-dose methylprednisolone is not closed. Nevertheless, maintenance of homeostasis remains the cornerstone of neuroprotection. SUMMARY: Subtle details differentiate the management of emergent and elective unstable C-spine patients. In both situations, the presence or the absence of a neurological insult governs the therapeutic strategy. [less ▲]

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See detailAcid-base status and hemodynamic stability during propofol and sevoflurane-based anesthesia in patients undergoing uncomplicated intracranial surgery.
Bonhomme, Vincent ULg; Demoitie, Jeannick ULg; Schaub, Isabelle ULg et al

in Journal of Neurosurgical Anesthesiology (2009), 21(2), 112-9

Propofol anesthesia may induce metabolic disturbances and sevoflurane anesthesia arterial hypotension. This study compares both techniques regarding acid-base and hemodynamic status during intracranial ... [more ▼]

Propofol anesthesia may induce metabolic disturbances and sevoflurane anesthesia arterial hypotension. This study compares both techniques regarding acid-base and hemodynamic status during intracranial surgery. Sixty-one patients were randomized into 2 groups according to anesthesia maintenance, a propofol group (n=30), and a sevoflurane group (n=31). The anesthesia protocol including rocuronium and remifentanil infusion was otherwise similar in both groups. Arterial blood samples were drawn every 2 hours during the procedure and upon arrival in the intensive care unit to assess acid-base status. The number of hypotensive and hypertensive events served to assess hemodynamic stability. Metabolic acidosis was more frequent during propofol than sevoflurane anesthesia (7 out of 29 and 1 out of 31, P=0.02). Its severity was linearly correlated with lactate concentration (R=0.32), total dose of propofol (R=0.2), and length of procedure (R=0.28). Hyperlactacidemia was also observed during sevoflurane anesthesia, but without acidosis. Hypertension occurred more frequently during propofol than sevoflurane anesthesia (13 out of 30 vs. 1 out of 31, P<0.001), particularly in patients with a past medical history of hypertension. Higher remifentanil infusion rates reduced the risk of hypertension. Conversely, sevoflurane anesthesia favored arterial hypotension (22 out of 31 vs. 12 out of 30, P=0.015). Preoperative morning administration of antihypertensive medications to patients with a history of arterial hypertension was associated with a low probability of hypertensive events, at the cost of more frequent hypotension. In conclusion, propofol anesthesia for intracranial surgery is more frequently associated with lactic acidosis and hypertension; sevoflurane anesthesia may favor arterial hypotension. [less ▲]

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See detailAwake craniotomy
Bonhomme, Vincent ULg; Franssen, Colette ULg; Hans, Pol ULg

in European Journal of Anaesthesiology (2009), 26(11), 906-912

Awake craniotomy has become an increasingly frequent procedure. In this paper, the principles of its anaesthetic management are reviewed. The means allowing achievement of anaesthetic objectives are ... [more ▼]

Awake craniotomy has become an increasingly frequent procedure. In this paper, the principles of its anaesthetic management are reviewed. The means allowing achievement of anaesthetic objectives are described, with emphasis on points that determine success of the procedure. A careful and adequate selection and preparation of patients are mandatory, and the intervening team must be a skilled team. Choosing an awake technique or general anaesthesia depends on several factors, including the risk of obstructive apnoea, seizures, nausea and vomiting, patient's ability to cooperate, and localization of lesions. The main challenge of intraoperative anaesthetic management relies on the ability of rapidly adjusting the level of sedation and analgesia according to the sequence of surgical events, while ensuring haemodynamic stability, adequate ventilation, and minimal interference with eventual eletrophysiological recordings. Throughout the procedure, complications must be anticipated and managed according to predefined guidelines. More prospective randomized clinical trials are still needed to improve safety and efficacy of awake craniotomies, as well as to validate this technique in comparison with more conventional anaesthetic management. [less ▲]

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See detailBispectral index correlates with regional cerebral blood flow during sleep in distinct cortical and subcortical structures in humans.
Noirhomme, Quentin ULg; Boly, Mélanie ULg; Bonhomme, Vincent ULg et al

in Archives Italiennes de Biologie (2009), 147(1-2), 51-7

The relationship between the Bispectral Index (BIS), an EEG-based monitor of anesthesia, and brain activity is still unclear. This study aimed at investigating the relationship between changes in BIS ... [more ▼]

The relationship between the Bispectral Index (BIS), an EEG-based monitor of anesthesia, and brain activity is still unclear. This study aimed at investigating the relationship between changes in BIS values during natural sleep and regional cerebral blood flow (rCBF) variations, as measured by Positron Emission Tomography (PET). Data were obtained from six young, healthy, right-handed, male volunteers (20-30 years old) using the H2(15)O infusion method. PET scans were performed both during waking and various stages of sleep. BIS values were monitored continuously and recorded during each PET scan. Positive correlations were detected between BIS and rCBF values in dorsolateral prefontal, parietal, anterior and posterior cingulate, precuneal, mesiofrontal, mesiotemporal and insular cortices. These areas belong to a frontoparietal network known to be related to awareness of self conscious sensory perception, attention and memory. BIS values also positively correlated with activity in brainstem and thalami, both structures known to be involved in arousal and wakefulness. These results show that BIS changes associated with physiological sleep depth co-vary with the activity of specific cortical and subcortical areas. The latter are known to modulate arousal, which in turn allows sustained thalamo-cortical enhancement of activity in a specific frontoparietal network known to be related to the content of consciousness. Thus, although mainly derived from frontal EEG, BIS could represent a wider index of cerebral activity. [less ▲]

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See detailThe Effect of Clonidine Infusion on Distribution of Regional Cerebral Blood Flow in Volunteers
Bonhomme, Vincent ULg; Maquet, Pierre ULg; Phillips, Christophe ULg et al

in Anesthesia and Analgesia (2008), 106(3), 899-909

BACKGROUND: Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this ... [more ▼]

BACKGROUND: Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this observational study was to map brain regions whose activity is modified by clonidine infusion so as to better understand its loci of action, especially in relation to sedation. METHODS: Six ASA I-II right-handed volunteers were recruited. Electroencephalogram (EEG) was monitored continuously. After a baseline H2(15)O activation scan, clonidine infusion was started at a rate ranging from 6 to 10 microg x kg(-1) x h(-1). A sequence of 11 similar scans was then performed at 8 min intervals. Plasma clonidine concentration was measured. Using statistical parametric mapping, we sought linear correlations between normalized regional cerebral blood flow (rCBF), an indicator of regional brain activity, and plasma clonidine concentration or spindle EEG activity. RESULTS: Clonidine induced clinical sedation and EEG patterns (spindles) comparable to early stage nonrapid eye movement sleep. A significant negative linear correlation between clonidine concentration and rCBF or spindle activity was observed in the thalamus, prefrontal, orbital and parietal association cortex, posterior cingulate cortex, and precuneus. CONCLUSIONS: The EEG patterns and decreases in rCBF of specific brain regions observed during clonidine-induced sedation are similar to those of early stage nonrapid eye movement sleep. Patterns of deactivated brain regions are also comparable to those observed during general anesthesia or vegetative state, reinforcing the hypothesis that alterations in the activity of a common network occur during these modified conscious states. [less ▲]

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See detailDelta down compared with delta pulse as an indicator of volaemia during intracranial surgery
Deflandre, Eric; Bonhomme, Vincent ULg; Hans, Pol ULg

in British Journal of Anaesthesia (2008), 100(2), 245-250

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See detailBrain function in physiologically, pharmacologically, and pathologically altered states of consciousness
Boveroux, Pierre ULg; Bonhomme, Vincent ULg; Vanhaudenhuyse, Audrey ULg et al

in International Anesthesiology Clinics (2008), 46(3), 131-146

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See detailIncreased analgesic requirements associated with induced labour are related to dystocia
Sougné, Christelle; Dewandre, Pierre-Yves ULg; Hans, Pol ULg et al

in Acta Anaesthesiologica Belgica (2008), 59(3), 229

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See detailEffect of propofol and sevoflurane on coughing in smokers and non-smokers awakening from general anaesthesia at the end of a cervical spine surgery.
Hans, Pol ULg; Marechal, Hugues ULg; Bonhomme, Vincent ULg

in British Journal of Anaesthesia (2008), 101(5), 731-7

BACKGROUND: Coughing during emergence from general anaesthesia may be detrimental, particularly after cervical spine surgery. We compared the effect of propofol or sevoflurane anaesthesia on the incidence ... [more ▼]

BACKGROUND: Coughing during emergence from general anaesthesia may be detrimental, particularly after cervical spine surgery. We compared the effect of propofol or sevoflurane anaesthesia on the incidence and severity of coughing during recovery in patients undergoing cervical spine surgery via an anterior approach. As a secondary aim, we also evaluated the influences of smoking and estimated residual anaesthetic agent concentrations on coughing. METHODS: Thirty-four patients were enrolled in a randomized prospective, double-blind study to receive either propofol (PPF) or sevoflurane (SEVO) for maintenance of anaesthesia. The decision to perform tracheal extubation was based on specified criteria, including resumption of spontaneous respiration and consciousness. During emergence from anaesthesia and extubation, coughing was observed and graded at predefined times. RESULTS: The incidence of severe coughing was higher in the SEVO group than in the PPF group (59% and 6%, respectively), and also in smokers than in non-smokers (50% and 17%, respectively). The peak incidence of coughing was at tracheal extubation. The probability of coughing was influenced by the estimated residual concentration of anaesthetic agents at extubation, except for smokers in the SEVO group who were at the highest risk of coughing. CONCLUSIONS: The incidence of coughing after cervical spine surgery when tracheal extubation is performed according to clinical criteria is lower after propofol anaesthesia compared with sevoflurane anaesthesia. Smokers are at increased risk of coughing, independently of the type of anaesthesia maintenance. Higher residual concentrations of anaesthetic agents decrease the probability of coughing, except for smokers anaesthetized with sevoflurane. [less ▲]

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See detailAnesthetic management for neurosurgery in awake patients
Hans, Pol ULg; Bonhomme, Vincent ULg

in Minerva Anestesiologica (2007), 73(10), 507-512

Neurnsurgery without general anesthesia is based on the necessity to avoid any interference between brain electrophysiological recordings and anesthetic agents, and the opportunity to have a patient able ... [more ▼]

Neurnsurgery without general anesthesia is based on the necessity to avoid any interference between brain electrophysiological recordings and anesthetic agents, and the opportunity to have a patient able to follow commands and to cooperate during surgery. It includes not only several minimally invasive procedures, but also craniotornies for epilepsy surgery or the removal of tumors located close to brain eloquent areas. Before surgery, the patient must be carefully evaluated, correctly informed and appropriately prepared. In the operating room, monitoring is important for conducting the anesthetic management, ensuring patient's comfort and safety, and meeting surgical requests. Propofol and remifentanil are frequently used for anesthesia, but sufentanil, local anesthetics and a2-agonists are also of primary interest. Patient's ventilation may be spontaneous, assisted or controlled. Airway management is a key point strongly related to the anesthesia technique and the type of surgery. Airway may be secured with different airway devices and the laryngeal mask appears to progressively replace the enclotracheal tube. Respiratory, hemodynamic, and neurologic complications as well as nausea and vomiting and loss of patient's cooperation may have disastrous consequences and should be prevented rather than cared. [less ▲]

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See detailMuscle relaxation and depth of anaesthesia: where is the missing link?
BONHOMME, Vincent ULg; Hans, Pol ULg

in British Journal of Anaesthesia (2007), 99(4), 456-460

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See detailBispectral Index profile during carotid cross clamping
Bonhomme, Vincent ULg; Desiron, Quentin ULg; Lemineur, Thierry et al

in Journal of Neurosurgical Anesthesiology (2007), 19(1), 49-55

This study aimed at investigating the Bispectral Index (BIS) profile during carotid cross clamping (CXC). The study involved a pilot group of 10 patients undergoing routine carotid endarterectomy with ... [more ▼]

This study aimed at investigating the Bispectral Index (BIS) profile during carotid cross clamping (CXC). The study involved a pilot group of 10 patients undergoing routine carotid endarterectomy with shunt insertion under total intravenous anesthesia, and a study group of 26 additional patients. In all patients, rates of propofol and remifentanil providing a steady-state level of hypnosis (BIS: 40-60) were maintained constant throughout a recording period ranging from 3 minutes before CXC to shunt insertion. BIS was recorded throughout this period and the internal carotid backflow observed at the time of shunt insertion was graded as good, moderate, or poor. In addition, A-Line Autoregressive Index (AAI) and processed electroencephalogram (EEG) parameters were recorded in patients of the study group. All parameters were averaged over I minute before CXC, at CXC, 1, 2, and 3 minutes after CXC, and at shunt insertion. Statistical analysis was performed using X 2, Friedman, and Spearman correlation tests. For technical reasons, reliable AAI, BIS monitor-derived, and other processed EEG data were obtained in 24, 25, and 18 patients of the study group, respectively. During the first 3 minutes after CXC, BIS increased over 60 [68.8 (6.1)] in 47%, decreased below 40 [34.9 (4.4)] in 25%, and remained in the 40 to 60 range in 28% of all recruited patients. A BIS increase was more frequently observed in patients with moderate or poor than in those with good internal carotid backflow (78, 67, and 29%, respectively). It was significantly correlated to an increase in AAI and EEG amplitude, a decrease in EEG suppression ratio, and a shorter time between induction of anesthesia and CXC. A BIS decrease was significantly correlated to an increase in suppression ratio and a longer time between induction and CXC. In conclusion, during CXC under a constant level of intravenous anesthesia, BIS may increase, decrease, or remain unchanged. The paradoxical BIS increase could be related to borderline ischemia, a change in brain anesthetic agent concentration, or a change in the nociceptive-antinociceptive balance associated with a CXC-elicited painful stimulation. Caution should be used when interpreting BIS value during CXC. [less ▲]

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See detailMonitorage de la profondeur de l'anesthésie: pourquoi, comment et a quel prix?
BONHOMME, Vincent ULg; Hans, Pol ULg

in Revue Médicale de Liège (2007), 62 Spec No

The precise titration of anaesthetic agents is necessary to avoid the consequences of a too light depth of anaesthesia such as unexpected intraoperative awareness, as well as a too deep level of ... [more ▼]

The precise titration of anaesthetic agents is necessary to avoid the consequences of a too light depth of anaesthesia such as unexpected intraoperative awareness, as well as a too deep level of anaesthesia, which can be deleterious in terms of postoperative morbidity and mortality. The clinical evaluation of the depth of anaesthesia is poorly sensitive and specific. It does not permit to distinguish between pharmacodynamic components of anaesthesia. Several paraclinical depth of anaesthesia indices are currently available. Most of them are mainly designed to monitor the depth of the hypnotic component of anaesthesia. Their calculation is mostly based on the mathematical analysis of the electroencephalogram. They are efficient at reducing the incidence of unexpected intraoperative awareness, adjusting anaesthetic depth at an individual scale, predicting the time needed for recovery, allowing early extubation of patients, reducing their length of stay in the post anaesthesia care unit, and limiting the number of episodes of peroperative over and under dosage of anaesthetic agents. The knowledge of conditions that may impede the accurate interpretation of those indices is mandatory for an optimal use. Although undoubtedly beneficial for the patients, the use of those monitors is frequently responsible for supplementary' costs, particularly when the procedure is short. [less ▲]

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See detailEffect of an intubation dose of rocuronium on Spectral Entropy and Bispectral Index (TM) responses to laryngoscopy during propofol anaesthesia
Hans, Pol ULg; Giwer, Jérôme ULg; Brichant, Jean-François ULg et al

in British Journal of Anaesthesia (2006), 97(6), 842-847

Background. The spectral entropy of the electroencephalogram has been proposed to monitor the depth of anaesthesia. State Entropy (SE) reflects the level of hypnosis. Response Entropy (RE), computed from ... [more ▼]

Background. The spectral entropy of the electroencephalogram has been proposed to monitor the depth of anaesthesia. State Entropy (SE) reflects the level of hypnosis. Response Entropy (RE), computed from electroencephalogram and facial muscle activity, reflects the response to nociceptive stimulation. We evaluated the effect of rocuronium on Bispectral Index (TM) (BIS) and entropy responses to laryngoscopy. Methods. A total of 25 patients were anaesthetized with propofol using a target-controlled infusion. At steady state, they randomly received 0.6 mg kg(-1) rocuronium (R) or saline (S). After 3 min, a 20 s laryngoscopy was applied. BIS, RE and SE were recorded continuously and averaged over 1 min during baseline, at steady state, 2 min after R or S administration (R/S+2) and 0, 1, 2 and 3 min after laryngoscopy (L0, L1, L2, L3). Results. At R/S+2, the RE-SE gradient was higher in Group S than in Group R. Laryngoscopy provoked an increase in BIS, RE and SE. Comparing R/S+2 and L0 values in Groups R and S, BIS increased from 43 (6) to 49 (8) and 42 (9) to 51 (15), SE increased from 43 (7) to 50 (8) and 41 (10) to 55 (12), and RE increased from 46 (8) to 54 (9) and 47 (12) to 66 (15), respectively. BIS and SE did not differ between groups. At L0, RE and RE-SE were higher in Group S [66 (15) and 11 (4), respectively] than in Group R [54 (9) and 4 (2), respectively]. Conclusions. Rocuronium alters the RE-SE gradient and the RE and RE-SE responses to laryngoscopy. Muscle relaxation may confound interpretation of entropy monitoring. [less ▲]

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See detailWhy We Still Use Intravenous Drugs as the Basic Regimen for Neurosurgical Anaesthesia
Hans, Pol ULg; BONHOMME, Vincent ULg

in Current Opinion in Anaesthesiology (2006), 19(5), 498-503

PURPOSE OF REVIEW: Evolution of neurosurgery mainly trends towards minimally invasive and functional procedures including endoscopies, small-size craniotomies, intraoperative imaging and stereotactic ... [more ▼]

PURPOSE OF REVIEW: Evolution of neurosurgery mainly trends towards minimally invasive and functional procedures including endoscopies, small-size craniotomies, intraoperative imaging and stereotactic interventions. Consequently, new adjustments of anaesthesia should aim at providing brain relaxation, minimal interference with electrophysiological monitoring, rapid recovery, patients' cooperation during surgery and neuroprotection. RECENT FINDINGS: In brain tumour patients undergoing craniotomy, propofol anaesthesia is associated with lower intracranial pressure and cerebral swelling than volatile anaesthesia. Hyperventilation used to improve brain relaxation may decrease jugular venous oxygen saturation below the critical threshold. It decreases the cerebral perfusion pressure in patients receiving sevoflurane, but not in those receiving propofol. The advantage of propofol over volatile agents has also been confirmed regarding interference with somatosensory, auditory and motor evoked potentials. Excellent and predictable recovery conditions as well as minimal postoperative side-effects make propofol particularly suitable in awake craniotomies. Finally, the potential neuroprotective effect of this drug could be mediated by its antioxidant properties which can play a role in apoptosis, ischaemia-reperfusion injury and inflammatory-induced neuronal damage. SUMMARY: Although all the objectives of neurosurgical anaesthesia cannot be met by one single anaesthetic agent or technique, propofol-based intravenous anaesthesia appears as the first choice to challenge the evolution of neurosurgery in the third millennium. [less ▲]

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See detailCorrelation and agreement between bispectral index and state entropy of the electroencephalogram during propofol anaesthesia
BONHOMME, Vincent ULg; Deflandre, Eric ULg; Deflandre, Eric

in British Journal of Anaesthesia (2006), 97(3), 340-346

Background. Bispectral index (BIS) and state entropy (SE) monitor hypnosis. We evaluated the correlation and the agreement between those parameters during propofol anaesthesia and laryngoscopy with and ... [more ▼]

Background. Bispectral index (BIS) and state entropy (SE) monitor hypnosis. We evaluated the correlation and the agreement between those parameters during propofol anaesthesia and laryngoscopy with and without muscle relaxation. Methods. A total of 25 patients were anaesthetized with propofol. At steady state (SS: BIS 40-50), they randomly received rocuronium (R) or saline (S); 3 min thereafter, a 20 s laryngoscopy was performed. Correlation (regression analysis) and agreement (Bland-Altman analysis) were evaluated before induction (baseline), at loss of eyelash reflex (LER), at SS and during the first 3 min after laryngoscopy (L). Results. The correlation coefficient r (95% CI), the mean difference (MD) (95% CI), and the limits of agreement [lower-upper limits of 95% CI of MD (sd 1.96)] between BIS and SE were as follows. Overall recordings: 0.87 (0.83 to 0.90), 2.5 (1.2 to 3.0), and [-19.5 to 24.6]; Baseline: 0.45 (0.06 to 0.72), 7.6 (6.0 to 9.2), and [-2.7 to 17.9]; LER: 0.74 (0.47 to 0.88), 8.3 (3.5 to 13.2), and [-22.6 to 39.3]; SS, all patients: 0.41 (0.14 to 0.63), 2.0 (-0.5 to 4.6), and [-19.0 to 23.3]; SS, Group S: 0.36 (-0.07 to 0.68), 1.9 (-2.5 to 6.3), and [-25.0 to 28.8]; SS, Group R: 0.63 (0.32 to 0.82), 0.2 (-2.0 to 2.3), and [-14.0 to 14.4]; L, all patients: 0.49 (0.32 to 0.63), 0.7 (-1.6 to 3.0), and [-25.6 to 27.1]; L, Group S: 0.41 (0.13 to 0.63), 2.3 (-2.4 to 7.1), and [-36.7 to 41.3]; L, Group R: 0.72 (0.56 to 0.83), -0.6 (-2.2 to 1.0), and [-14.3 to 13.1]. The correlation was good except for SS in Group S. The MD was significantly different from 0 for overall recordings, during baseline and LER, but not for the other conditions. The agreement was poor except for baseline, and SS and L in Group R. Conclusions. BIS and SE are globally well correlated. In contrast, agreement is poor as differences of more than 20 units are frequently observed, except for awake and paralysed patients. [less ▲]

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See detailBlood glucose concentration profile after 10 mg dexamethasone in non-diabetic and type 2 diabetic patients undergoing abdominal surgery
Hans, Pol ULg; Vanthuyne, A.; Dewandre, Pierre-Yves et al

in British Journal of Anaesthesia (2006), 97(2), 164-170

BACKGROUND: Dexamethasone prevents postoperative nausea and vomiting but may increase blood glucose. We compared blood glucose concentrations after dexamethasone in non-diabetic and type 2 diabetic ... [more ▼]

BACKGROUND: Dexamethasone prevents postoperative nausea and vomiting but may increase blood glucose. We compared blood glucose concentrations after dexamethasone in non-diabetic and type 2 diabetic patients undergoing surgery and looked for any association with preoperative glycosylated haemoglobin [HbA (1c)] and BMI. METHODS: Sixty three patients were enrolled: 32 were non-diabetic (Group ND) and 31 type 2 diabetic (Group D) without insulin treatment. Anaesthesia was induced using i.v. anaesthetic agents and maintained with sevoflurane. All patients received 10 mg dexamethasone at induction. Blood glucose concentrations were measured at induction and then every 60 min for 240 min. Data were analysed using anova. Effects of HbA (1c) and BMI were investigated using linear correlation and logistic regression. RESULTS: Blood glucose concentrations increased significantly over time and peaked at 120 min after 10 mg dexamethasone in both groups. The magnitude of increase was comparable between the groups [mean (SD) 29 (19) and 35 (19)% of baseline in Group D and Group ND, respectively]. Maximum concentrations were higher in Group D [8.97 (1.51) mmol litre(-1), range 6.67-12.94 mmol litre(-1)] than in Group ND [7.86 (1.00) mmol litre(-1), range 5.78-10.00 mmol litre(-1)]. There was a significant correlation between the maximum concentrations and BMI (R(2)=0.21) or HbA (1c) (R(2)=0.26). Logistic regression analysis revealed that the higher the BMI, the lower the HbA (1c) threshold associated with an increased probability (>0.5) of observing blood glucose levels higher than 8.33 mmol litre(-1) during 240 min after dexamethasone administration. Similarly, the higher the HbA (1c), the lower the BMI threshold associated with the same probability. CONCLUSIONS: After 10 mg dexamethasone, blood glucose levels increase in non-diabetic and type 2 diabetic patients undergoing abdominal surgery. Poorly controlled diabetes and severe obesity can influence the development of hyperglycaemia. [less ▲]

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