Evidence map›Paper›PMID 32636880›Full record

ArticleAnesthesiology research and practice2020

High Incidence of Burst Suppression during Propofol Sedation for Outpatient Colonoscopy: Lessons Learned from Neuromonitoring.

Jamie Bloom, David Wyler, Marc C Torjman, Tuan Trinh, Lucy Li, Amy Mehta, Evan Fitchett, David Kastenberg, Michael Mahla, Victor Romo

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Anesthesiology research and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06225037 (EEG-guided Propofol Sedation Versus Standard Care for Oesophagogastroduodenoscopy and Colonoscopy in Children), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06225037 nacompletednot on this mapstarted 2023, after this paper: background citation

EEG-guided Propofol Sedation Versus Standard Care for Oesophagogastroduodenoscopy and Colonoscopy in Children: A Randomised Controlled Trial to Improve Sedation Safety and Experience

TypeinterventionalSponsorKK Women's and Children's HospitalRan2023 to 2024Enrolled50ConditionsAnesthesia, Anesthesia, Adverse Effect, Anesthesia Emergence DeliriumArmsSedline EEG monitoring, Sedline EEG with output concealed
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Jamie BloomDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.ORCID https://orcid.org/0000-0002-5791-3113
David WylerDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.
Marc C TorjmanDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.
Tuan TrinhDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.
Lucy LiSidney Kimmel Medical College, 1025 Walnut Street, Philadelphia, PA 19107, USA.
Amy MehtaDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.
Evan FitchettSidney Kimmel Medical College, 1025 Walnut Street, Philadelphia, PA 19107, USA.
David KastenbergDepartment of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University, 132 S. 10 Street, Philadelphia, PA 19107, USA.
Michael MahlaDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.
Victor RomoDepartment of Anesthesiology, Division of Neurological Anesthesia, Thomas Jefferson University, 111 S. 11 Street, Philadelphia, PA 19107, USA.ORCID https://orcid.org/0000-0003-4378-0097
Thomas Jefferson University · USSidney Kimmel Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough anesthesia providers may plan for moderate sedation, the depth of sedation is rarely quantified. Using processed electroencephalography (EEG) to assess the depth of sedation, this study investigates the incidence of general anesthesia with variable burst suppression in patients receiving propofol for outpatient colonoscopy. The lessons learned from neuromonitoring can then be used to guide institutional best sedation practice.

methodsThis was a prospective observational study of 119 outpatients undergoing colonoscopy at Thomas Jefferson University Hospital (TJUH). Propofol was administered by CRNAs under anesthesiologists' supervision. The Patient State Index (PSi™) generated by the Masimo SedLine® Brain Root Function monitor (Masimo Corp., Irvine, CA) was used to assess the depth of sedation. PSi data correlating to general anesthesia with variable burst suppression were confirmed by neuroelectrophysiologists' interpretation of unprocessed EEG.

resultsPSi values of <50 consistent with general anesthesia were attained in 118/119 (99.1%) patients. Of these patients, 33 (27.7%) attained PSi values <25 consistent with variable burst suppression. The 118 patients that reached PSi <50 spent a significantly greater percentage (53.1% vs. 42%) of their case at PSi levels <50 compared to PSi levels >50 (

conclusionAlthough providers planned for moderate to deep sedation, processed EEG showed patients were under general anesthesia, often with burst suppression. Anesthesiologists and endoscopists may utilize processed EEG to recognize their institutional practice patterns of procedural sedation with propofol and improve upon it.

Identifiers

PMID32636880
PMCPMC7321500
OpenAlexW3036543793

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.