Target Controlled Infusion via Smartpilot? view for Neuromonitoring in Neurosurgical Patients: A Novel Technology

Inan G* and Satirlar Ozkose Z

Department of Anesthesiology and Reanimation, Gazi University, Ankara, Turkey

^*Correspondance to: Gozde Inan 

 PDF  Full Text DOI: 10.25107/2474-1647.3165

Abstract

Background: Intravenous anesthetic administration utilizing pharmacokinetic/pharmacodynamic models during Intraoperative Neurophysiologic Monitoring (INM) has never been investigated. SmartPilot? View (SPV) is a software that takes into account hypnotic-opioid interactions and produces Noxious Stimulation Response Index (NSRI) to determine various levels of anesthesia. The goal was to investigate whether the efficacy of Target Controlled Infusion (TCI) could be optimized without affecting INM parameters via SPV technology. Methods: Patients underwent neurosurgery with INM between January 1st, 2018 to January 1st, 2019 were retrospectively documented. The subjects were divided into two groups following data scanning: Those monitored with SPV (Group SPV) and those undergone standard anesthesia follow-up (Group Control). The analysis included hemodynamic parameters, BIS, anesthesia and surgery times, extubation time, and anesthesia consumption. For Group SPV, the relationship between hypotensive episodes as well as anesthesia time spent in each isobole and alterations of neuromonitoring signals was analyzed. Results: Data from 43 patients were included in this analysis (n=20 SPV; 23 control). Both groups had similar demographic data. Extubation time (p=0.013) and total anesthesia time spent with mean arterial pressure 90 (p=0.0011) and prolongation in latency and decrease in amplitude of neuromonitoring signals. Conclusion: By reducing intraoperative hypotension time, SPV-guided TCI improved intraoperative hemodynamics and was effective in optimizing intravenous anesthesia without influencing INM signals during neuromonitoring.

Keywords

Intraoperative neurophysiologic monitoring; Anesthetics; Intravenous; Consciousness monitors; Monitoring; Intraoperative

Cite the article

Inan G, Satirlar Ozkose Z. Target Controlled Infusion via Smartpilot? view for Neuromonitoring in Neurosurgical Patients: A Novel Technology. Clin Surg. 2021; 6: 3165..