Evidence map›Paper›PMID 36967282›Full record

Trial reportBritish journal of anaesthesia2023

Breathe-squeeze: pharmacodynamics of a stimulus-free behavioural paradigm to track conscious states during sedation

Christian S Guay, Darren Hight, Gaurang Gupta, MohammadMehdi Kafashan, Anhthi H Luong, Michael S Avidan, Emery N Brown, Ben Julian A Palanca

Registry-linked trialAbstract readClinical Trial
In one paragraph

Trial report in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04206059 (Closed Loop Acoustic Stimulation During Sedation With Dexmedetomidine), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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.

NCT04206059 nacompletednot on this map

Closed Loop Acoustic Stimulation During Sedation With Dexmedetomidine

TypeinterventionalSponsorWashington University School of MedicineRan2021 to 2023Enrolled18ConditionsSleep, Sedation ComplicationArmsMRI, Quantitative Sensory Testing (QST), Home sleep study, Acoustic stimulation (65 decibels or db) up-slope of EEG with QST, Acoustic stimulation (65db) down-slope of EEG with QST
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Dreaming during anaesthesia: a scoping review.British journal of anaesthesia · 2026
    Article
  2. Review
  3. Article
  4. Article
  5. Article
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

8 authors.

Christian S GuayDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: cguay2@mgh.harvard.edu.
Darren HightDepartment of Anaesthesiology & Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Gaurang GuptaDepartment of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
MohammadMehdi KafashanDepartment of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Anhthi H LuongColumbia University Mailman School of Public Health, New York, NY, USA.
Michael S AvidanDepartment of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Emery N BrownDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA.
Ben Julian A PalancaDepartment of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA; Center on Biological Rhythms and Sleep, Washington University in St. Louis, St. Louis, MO, USA.

Funding

Project 4: Mathematical Modeling Studies of Anesthetic ActionP01GM118269 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI BROWN, EMERY N · 2017 to 2021
$9.0M
Disruptions of Brain Networks and Sleep by Electroconvulsive TherapyK01MH128663 · NIMH · WASHINGTON UNIVERSITY · PI MohammadMehdi Kafashan · 2022 to 2026
$792k
NIGMS NIH HHS P01 GM118269NIMH NIH HHS K01 MH128663
6 · The paper itself

Abstract

backgroundConscious states are typically inferred through responses to auditory tasks and noxious stimulation. We report the use of a stimulus-free behavioural paradigm to track state transitions in responsiveness during dexmedetomidine sedation. We hypothesised that estimated dexmedetomidine effect-site (Ce) concentrations would be higher at loss of responsiveness (LOR) compared with return of responsiveness (ROR), and both would be lower than comparable studies that used stimulus-based assessments.

methodsClosed-Loop Acoustic Stimulation during Sedation with Dexmedetomidine data were analysed for secondary analysis. Fourteen healthy volunteers were asked to perform the breathe-squeeze task of gripping a dynamometer when inspiring and releasing it when expiring. LOR was defined as five inspirations without accompanied squeezes; ROR was defined as the return of five inspirations accompanied by squeezes. Brain states were monitored using 64-channel EEG. Dexmedetomidine was administered as a target-controlled infusion, with Ce estimated from a pharmacokinetic model.

resultsCounter to our hypothesis, mean estimated dexmedetomidine Ce was lower at LOR (0.92 ng ml

conclusionsThe breathe-squeeze task can effectively track changes in responsiveness during sedation without external stimuli and might be more sensitive to state changes than stimulus-based tasks. It should be considered when perturbation of brain states is undesirable. CLINICAL

trial registrationNCT04206059.

Indexed as

DexmedetomidineHypnotics and SedativesBrainConsciousnessElectroencephalographyHumansProcedural SedationDexmedetomidineHypnotics and SedativesconsciousnessdexmedetomidineEEGmonitorresponsivenesssedationsensory disconnectionsleep

Identifiers

PMID36967282
PMCPMC11140841

What OpenQuestion holds

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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.