Original Research Article
Year: 2020 | Month: April | Volume: 7 | Issue: 4 | Pages: 179-188
A Clinical Study of the Utility and Efficacy of Monitoring Depth of Anaesthesia with Auditory Evoked Potentials and Its Use in Assessing Effect of Premedication with Oral Clonidine on Intraoperative Requirements of Inhalational Anaesthetics
Ajay Chandra1, Ajit Kumar Singh2, Maninder K Grewal3, Anurag Garg4, Vivek B Sharma1
1Assoc Prof., 4Sr. Resident,
Department of Anaesthesiology and Critical Care, Research and Referral, Army Hospital, Delhi, India. 110010
2Assoc Prof, Department Of Anaesthesiology and Critical Care, Command Hospital, Chandimandir, Panchkula, India. 134107
3Asst Prof., Department Of Anaesthesiology and Critical Care, Moolchand Hospital, New Delhi, India. 110010
Corresponding Author: Ajit Kumar Singh
ABSTRACT
Background: General anaesthesia (GA) reversibly depresses central nervous system (CNS) resulting in the loss of response and perception of all external stimuli. Against this background, this study was conducted in patients undergoing surgery under GA to stress that monitoring depth of anaesthesia with using Auditory Evoked Potentials helps dose reduction of volatiles and early recovery.
Materials and Methods: A total of 100 patients after applying exclusion and inclusion criteria, undergoing elective surgical procedures under GA, were enrolled in the study. They were divided randomly in three groups of Gp 1 - Control - 34, Gp 2- 33 and Gp- 3 Premedicated -33. AEP monitor was used in Gp 2 and 3 to assess the depth of Anaesthesia and was compared with Gp 1 in terms of duration, dosage of isoflurane and recovery . Data recorded were analyzed using relevant statistical test.
Result: Patients in Gp 1, without AEP monitoring required higher doses of isoflurane (0.51%). In comparision to AEP monitored groups (B- 0.35(0.03) and Gp C-34(0.01) Vol%. The emergence (e.g., awakening), orientation, and extubation times were significantly reduced in the AEP-monitored (vs. control) group (< 0.05). The duration of recovery room stay was significantly reduced in the AEP-monitored (vs. control) group(< 0.05).. There were no differences between the two groups with respect to pain scores and opioid analgesic consumption. None of the patients reported recall of any intraoperative events.
Conclusion: Auditory evoked potential monitoring and premedication with an Agonist Clonidine reduces the volatile anaesthetic (Isoflurane) consumption compared to, standard monitoring to assess the depth of anaesthesia and helps in early recovery.
Keywords: Isoflurane, Auditory Evoked Potential, awareness, Monitoring, BIS
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