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  1. Article: Central nervous system monitoring during open heart surgery: an update.

    Sebel, P S

    Journal of cardiothoracic and vascular anesthesia

    1998  Volume 12, Issue 2 Suppl 1, Page(s) 3–8

    Abstract: Electroencephalography (EEG) is used to monitor the function of the central nervous system in a variety of surgical procedures. During cardiac surgery with cardiopulmonary bypass, ischemic changes on the EEG as a result of impaired central nervous system ...

    Abstract Electroencephalography (EEG) is used to monitor the function of the central nervous system in a variety of surgical procedures. During cardiac surgery with cardiopulmonary bypass, ischemic changes on the EEG as a result of impaired central nervous system blood supply can be noted. The EEG also may be used to monitor the functional state of the brain during and after profound hypothermic circulatory arrest. If a desired goal is to reduce cerebral metabolism using a barbiturate or other such agent, the EEG can be monitored to provide a measurable pharmacodynamic end point (burst suppression). Techniques have been developed to process the EEG signal using a computer and to improve on-line interpretation. These include fast Fourier transformation to develop a three-dimensional plot or compressed spectral array, evoked-potential monitoring, and bispectral analysis to derive a univariate descriptor of the EEG. These techniques have been used to detect awareness and indirect memory function, as well as to assess the adequacy of anesthesia. There is a good correlation between implicit memory and alterations in midlatency auditory-evoked responses. The bispectral index has been used to assess the adequacy of anesthesia as well as to detect awareness. Preliminary studies suggest that titrating the anesthetic to bispectral index levels may be useful during cardiac surgery.
    MeSH term(s) Anesthetics, General/administration & dosage ; Barbiturates/administration & dosage ; Brain/drug effects ; Brain/metabolism ; Brain/physiology ; Brain Ischemia/prevention & control ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Electroencephalography/drug effects ; Evoked Potentials/physiology ; Evoked Potentials, Auditory/physiology ; Fourier Analysis ; Heart Arrest, Induced ; Humans ; Hypothermia, Induced ; Memory/physiology ; Monitoring, Intraoperative ; Signal Processing, Computer-Assisted
    Chemical Substances Anesthetics, General ; Barbiturates
    Language English
    Publishing date 1998-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
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  2. Article: Awareness during general anesthesia.

    Sebel, P S

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    1997  Volume 44, Issue 5 Pt 2, Page(s) R124–30

    MeSH term(s) Anesthesia, General ; Awareness ; Humans
    Language French
    Publishing date 1997-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/bf03022271
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  3. Article: Anaesthesia practitioners in the UK: the high road, not yet taken.

    Green, D / Sebel, P S

    European journal of anaesthesiology

    2006  Volume 23, Issue 11, Page(s) 899–901

    MeSH term(s) Anesthesiology/education ; Anesthesiology/standards ; Anesthesiology/trends ; Humans ; Nurse Anesthetists/education ; Nurse Anesthetists/supply & distribution ; Physician Assistants/education ; Physician Assistants/standards ; Physician Assistants/supply & distribution ; Program Development/standards ; Staff Development/standards ; United Kingdom
    Language English
    Publishing date 2006-08-02
    Publishing country England
    Document type Editorial
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1017/s0265021506001384
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  4. Article: Awareness and different forms of memory in trauma anaesthesia.

    Lubke, G H / Sebel, P S

    Current opinion in anaesthesiology

    2006  Volume 13, Issue 2, Page(s) 161–165

    Abstract: Awareness during surgery and memory for perioperative events may have substantial psychological consequences for the patient. The risk of awareness during trauma surgery is higher than during most elective procedures due to the fact that administration ... ...

    Abstract Awareness during surgery and memory for perioperative events may have substantial psychological consequences for the patient. The risk of awareness during trauma surgery is higher than during most elective procedures due to the fact that administration of adequate concentrations of anaesthetics is not always feasible. As a consequence, the risk of memory formation might be increased. The present review discusses different forms of memory, and the possibilities and limitations of awareness and memory prevention.
    Language English
    Publishing date 2006-09-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645203-6
    ISSN 1473-6500 ; 0952-7907
    ISSN (online) 1473-6500
    ISSN 0952-7907
    DOI 10.1097/00001503-200004000-00013
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  5. Article: Memory during anesthesia: gone but not forgotten?

    Sebel, P S

    Anesthesia and analgesia

    1995  Volume 81, Issue 4, Page(s) 668–670

    MeSH term(s) Anesthesia ; Humans ; Memory/drug effects ; Memory/physiology ; Suggestion
    Language English
    Publishing date 1995-10
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1097/00000539-199510000-00002
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  6. Article ; Online: Preserved memory function during bispectral index-guided anesthesia with sevoflurane for major orthopedic surgery.

    Kerssens, Chantal / Gaither, Julie R / Sebel, Peter S

    Anesthesiology

    2009  Volume 111, Issue 3, Page(s) 518–524

    Abstract: ... P = 0.001). Target hit rates correlated poorly to stress scores (P > 0.9), but were associated ... with the amount of fentanyl received preoperatively (P = 0.01) and pain management technique (P < 0.01 ...

    Abstract Background: Memory function under anesthesia is undesired but may arise from light hypnosis as well as stress-enhanced learning during surgery. The bispectral index (BIS, Aspect Medical Systems, Norwood, MA) is a monitor of hypnotic state that can help to avoid light hypnosis (i.e., BIS above 60). This study tested the hypothesis that BIS-guided anesthesia maintaining BIS 50-60 reduces the likelihood of memory function under anesthesia.
    Methods: After obtaining informed consent, 128 patients scheduled for joint replacement surgery under general anesthesia with sevoflurane were randomly assigned to BIS-guided anesthesia, titrating drugs to BIS 50-60 (BIS group), or a standard practice group in which BIS was recorded but did not guide drug administration. After induction, all patients were repeatedly played a list of 15 words. After recovery from anesthesia, all were interviewed about recall and completed a recognition memory test containing the presented words (targets, 33.3%) and new words (distractors). Preoperatively, patients filled out a stress questionnaire (Spielberger State-Trait Anxiety Inventory).
    Results: BIS values above 60 were recorded in both groups, but no patient recalled the presented words postoperatively. Only patients in the BIS group selected targets more often than distractors (37.1% vs. 31.5% hit rate, P = 0.001). Target hit rates correlated poorly to stress scores (P > 0.9), but were associated with the amount of fentanyl received preoperatively (P = 0.01) and pain management technique (P < 0.01).
    Conclusions: BIS titration to BIS 50-60 does not necessarily curb memory function under anesthesia when BIS values higher than 60 occur. Preoperative analgesia attenuated the likelihood of memory function under anesthesia.
    MeSH term(s) Adjuvants, Anesthesia ; Aged ; Anesthesia, General ; Anesthetics, Inhalation ; Awareness/drug effects ; Dreams ; Electroencephalography/drug effects ; Female ; Fentanyl ; Humans ; Male ; Memory/drug effects ; Mental Recall ; Methyl Ethers ; Middle Aged ; Monitoring, Intraoperative/methods ; Neuropsychological Tests ; Orthopedic Procedures ; Recognition (Psychology)/drug effects ; Recognition (Psychology)/physiology ; Stress, Psychological/psychology
    Chemical Substances Adjuvants, Anesthesia ; Anesthetics, Inhalation ; Methyl Ethers ; sevoflurane (38LVP0K73A) ; Fentanyl (UF599785JZ)
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0b013e3181b05f0b
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  7. Article: Development and clinical application of electroencephalographic bispectrum monitoring.

    Johansen, J W / Sebel, P S

    Anesthesiology

    2000  Volume 93, Issue 5, Page(s) 1336–1344

    MeSH term(s) Anesthesia, General/methods ; Clinical Trials as Topic ; Electroencephalography/methods ; Humans ; Monitoring, Intraoperative/methods ; Signal Processing, Computer-Assisted
    Language English
    Publishing date 2000-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 269-0
    ISSN 0003-3022
    ISSN 0003-3022
    DOI 10.1097/00000542-200011000-00029
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  8. Article: Transatlantic lessons: one man's view.

    Sebel, P S

    Anesthesia and analgesia

    1987  Volume 66, Issue 8, Page(s) 800–801

    MeSH term(s) Anesthesia/economics ; Anesthesiology/instrumentation ; United Kingdom ; United States
    Language English
    Publishing date 1987-08
    Publishing country United States
    Document type Comparative Study ; Letter
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
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  9. Article: Evaluation of anaesthetic depth.

    Sebel, P S

    British journal of hospital medicine

    1987  Volume 38, Issue 2, Page(s) 116–7, 120–1, 124

    Abstract: The state of anaesthesia is one of unconsciousness, lack of awareness, amnesia and reflex suppression to noxious stimuli. The depth of anaesthesia is generally considered adequate if the patient neither moves in response to surgical stimulus nor shows ... ...

    Abstract The state of anaesthesia is one of unconsciousness, lack of awareness, amnesia and reflex suppression to noxious stimuli. The depth of anaesthesia is generally considered adequate if the patient neither moves in response to surgical stimulus nor shows any signs of autonomic reflexes. Anaesthesia is generally considered inadequate if the patient has recall after surgery!
    MeSH term(s) Anesthesia ; Anesthetics/pharmacology ; Autonomic Nervous System/drug effects ; Consciousness/drug effects ; Electroencephalography ; Electromyography ; Esophagus/drug effects ; Evoked Potentials/drug effects ; Humans ; Muscle Contraction/drug effects ; Muscle, Smooth/drug effects
    Chemical Substances Anesthetics
    Language English
    Publishing date 1987-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 604230-2
    ISSN 1759-7390 ; 0007-1064 ; 1462-3935 ; 1750-8460
    ISSN (online) 1759-7390
    ISSN 0007-1064 ; 1462-3935 ; 1750-8460
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  10. Article: Effect of hypothermia on median nerve somatosensory evoked potentials.

    Sebel, P S / de Bruijn, N P / Neville, W K

    Journal of cardiothoracic anesthesia

    2006  Volume 2, Issue 3, Page(s) 326–329

    Abstract: ... rectal) (r = -.91, P < .001). for cortical latency and esophageal temperature. A decrease in esophageal ...

    Abstract Median nerve somatosensory evoked potentials (SEP) were monitored in ten patients undergoing cardiac surgery with hypothermic cardiopulmonary bypass (CPB). Anesthesia was induced and maintained with sufentanil, oxygen, and pancuronium. Esophageal, nasopharyngeal, rectal, and blood temperatures were continuously monitored. SEPs were recorded before induction of anesthesia, after induction, and during cooling and rewarming on CPB. There was a strong negative correlation between SEP latencies and temperature (except rectal) (r = -.91, P < .001). for cortical latency and esophageal temperature. A decrease in esophageal temperature of 1 degrees C resulted in an increase in SEP latency of 1 ms. There was also a weak positive correlation between evoked potential amplitude and temperature (r = .19) for cortical amplitude and esophageal temperature.
    MeSH term(s) Body Temperature/physiology ; Cardiopulmonary Bypass/methods ; Evoked Potentials, Somatosensory ; Female ; Humans ; Hypothermia, Induced/methods ; Hypothermia, Induced/statistics & numerical data ; Male ; Median Nerve/physiology ; Middle Aged ; Monitoring, Intraoperative/methods ; Reaction Time/physiology ; Time Factors
    Language English
    Publishing date 2006-12-12
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 633000-9
    ISSN 1878-0660 ; 0888-6296
    ISSN (online) 1878-0660
    ISSN 0888-6296
    DOI 10.1016/0888-6296(88)90313-4
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