Prediction of Bispectral Index during Target-controlled Infusion of Propofol and Remifentanil: A Deep Learning Approach.

Abstract:

BACKGROUND:The discrepancy between predicted effect-site concentration and measured bispectral index is problematic during intravenous anesthesia with target-controlled infusion of propofol and remifentanil. We hypothesized that bispectral index during total intravenous anesthesia would be more accurately predicted by a deep learning approach. METHODS:Long short-term memory and the feed-forward neural network were sequenced to simulate the pharmacokinetic and pharmacodynamic parts of an empirical model, respectively, to predict intraoperative bispectral index during combined use of propofol and remifentanil. Inputs of long short-term memory were infusion histories of propofol and remifentanil, which were retrieved from target-controlled infusion pumps for 1,800 s at 10-s intervals. Inputs of the feed-forward network were the outputs of long short-term memory and demographic data such as age, sex, weight, and height. The final output of the feed-forward network was the bispectral index. The performance of bispectral index prediction was compared between the deep learning model and previously reported response surface model. RESULTS:The model hyperparameters comprised 8 memory cells in the long short-term memory layer and 16 nodes in the hidden layer of the feed-forward network. The model training and testing were performed with separate data sets of 131 and 100 cases. The concordance correlation coefficient (95% CI) were 0.561 (0.560 to 0.562) in the deep learning model, which was significantly larger than that in the response surface model (0.265 [0.263 to 0.266], P < 0.001). CONCLUSIONS:The deep learning model-predicted bispectral index during target-controlled infusion of propofol and remifentanil more accurately compared to the traditional model. The deep learning approach in anesthetic pharmacology seems promising because of its excellent performance and extensibility.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Lee HC,Ryu HG,Chung EJ,Jung CW

doi

10.1097/ALN.0000000000001892

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

492-501

issue

3

eissn

0003-3022

issn

1528-1175

journal_volume

128

pub_type

杂志文章
  • Anterior shift of the dominant EEG rhytham during anesthesia in the Java monkey: correlation with anesthetic potency.

    abstract::EEG amplitude dominance in awake man is posterior. During EEG monitoring in patients, the authors observed the abrupt appearance of anterior amplitude dominance during induction of anesthesia with halothane, enflurane, or thiopental. This EEG change is coincident with loss of eyelid reflex and loss of ability to respo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197704000-00005

    authors: Tinker JH,Sharbrough FW,Michenfelder JD

    更新日期:1977-04-01 00:00:00

  • Intergenerational Effects of Sevoflurane in Young Adult Rats.

    abstract:BACKGROUND:Sevoflurane administered to neonatal rats induces neurobehavioral abnormalities and epigenetic reprogramming of their germ cells; the latter can pass adverse effects of sevoflurane to future offspring. As germ cells are susceptible to reprogramming by environmental factors across the lifespan, the authors hy...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002920

    authors: Ju LS,Yang JJ,Xu N,Li J,Morey TE,Gravenstein N,Seubert CN,Setlow B,Martynyuk AE

    更新日期:2019-11-01 00:00:00

  • Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia.

    abstract:BACKGROUND:Pain following thoracotomy can persist for years with an undetermined impact on quality of life. Factors hypothesized to modulate this painful experience include analgesic regimen, gender, and type of incision. METHODS:A total of 157 generally healthy patients of both genders scheduled for segmentectomy, lo...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200211000-00029

    authors: Ochroch EA,Gottschalk A,Augostides J,Carson KA,Kent L,Malayaman N,Kaiser LR,Aukburg SJ

    更新日期:2002-11-01 00:00:00

  • Sufentanil disposition. Is it affected by erythromycin administration?

    abstract:BACKGROUND:Because oral erythromycin administration has been associated with reduced elimination of alfentanil, suspicion has been raised about related opioids with similar metabolic pathways. A controlled crossover study of sufentanil pharmacokinetics was undertaken to resolve this issue. METHODS:Six subjects had mea...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Bartkowski RR,Goldberg ME,Huffnagle S,Epstein RH

    更新日期:1993-02-01 00:00:00

  • Inhalation anesthetics inhibit the release of endothelium-derived hyperpolarizing factor in the rabbit carotid artery.

    abstract:BACKGROUND:Inhalation anesthetics may interfere with the synthesis or action of endothelium-derived vasoactive factors. We investigated the effects of desflurane, enflurane, halothane, isoflurane, and sevoflurane on the release of nitric oxide and endothelium-derived hyperpolarizing factor (EDHF) in the isolated endoth...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199509000-00017

    authors: Lischke V,Busse R,Hecker M

    更新日期:1995-09-01 00:00:00

  • Sympathetic ganglionic blockade masks beneficial effect of isoflurane on histologic outcome from near-complete forebrain ischemia in the rat.

    abstract:BACKGROUND:Isoflurane-anesthetized rats have better outcome from global cerebral ischemia than rats anesthetized with fentanyl and nitrous oxide. The authors wanted to determine whether circulating catecholamine concentrations depend on the anesthetic agent and whether sympathetic ganglionic blockade affects anesthetic...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199903000-00031

    authors: Mackensen GB,Nellgård B,Miura Y,Chu CT,Dexter F,Pearlstein RD,Warner DS

    更新日期:1999-03-01 00:00:00

  • Direct assessments of the antioxidant effects of propofol medium chain triglyceride/long chain triglyceride on the brain of stroke-prone spontaneously hypertensive rats using electron spin resonance spectroscopy.

    abstract:BACKGROUND:Antioxidant anesthetics such as propofol (2,6-diisopropylphenol) directly inhibit lipid peroxidation via the generation of reactive oxygen species. Currently, there are no other studies regarding the direct effects of propofol medium chain triglyceride/long chain triglyceride (MCT/LCT) on reactive oxygen spe...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318182a903

    authors: Kobayashi K,Yoshino F,Takahashi SS,Todoki K,Maehata Y,Komatsu T,Yoshida K,Lee MC

    更新日期:2008-09-01 00:00:00

  • Combined epidural and general anesthesia versus general anesthesia for abdominal aortic surgery.

    abstract::The goal of this randomized study of high-risk surgical patients was to determine whether intraoperative thoracic epidural anesthesia in combination with light general anesthesia alters postoperative morbidity when compared to a standard technique of "balanced" general anesthesia. A total of 173 patients scheduled for...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199110000-00010

    authors: Baron JF,Bertrand M,Barré E,Godet G,Mundler O,Coriat P,Viars P

    更新日期:1991-10-01 00:00:00

  • Protective effect of hypothermia in cerebral oxygen deficiency caused by arterial hypoxia.

    abstract::To study the cerebral protective effects of hypothermia in arterial hypoxia, anesthetized (70% N2O), mechanically ventilated rats were cooled to a body temperature of 27 C. Hypoxia was induced by decreasing the oxygen content in the inspired gas mixture either to 6-7 per cent or to 2.5-3 per cent. This reduced mean Pa...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197601000-00006

    authors: Carlsson C,Hägerdal M,Siesjö BK

    更新日期:1976-01-01 00:00:00

  • Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery.

    abstract:BACKGROUND:Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce bleeding and transfusion requirements during scoliosis surgery. METHODS:Forty-four patien...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200504000-00006

    authors: Sethna NF,Zurakowski D,Brustowicz RM,Bacsik J,Sullivan LJ,Shapiro F

    更新日期:2005-04-01 00:00:00

  • Thiopental requirements for induction of anesthesia in neonates and in infants one to six months of age.

    abstract::The authors determined the thiopental dose needed for satisfactory induction in ten neonates, 0-14 days of age, and 20 infants, 1-6 months of age. A single iv bolus of thiopental was given. Thirty seconds after injection the anesthesia mask was applied and the response was observed during the following 30 s while the ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198909000-00004

    authors: Westrin P,Jonmarker C,Werner O

    更新日期:1989-09-01 00:00:00

  • Gum elastic bougie-guided insertion of the ProSeal laryngeal mask airway is superior to the digital and introducer tool techniques.

    abstract:BACKGROUND:The authors compare three techniques for insertion of the ProSeal laryngeal mask airway. METHODS:Two hundred forty healthy patients aged 18-80 yr were randomly allocated for ProSeal laryngeal mask airway insertion using the digital, introducer tool (IT), or gum elastic bougie (GEB)-guided techniques. The di...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200401000-00008

    authors: Brimacombe J,Keller C,Judd DV

    更新日期:2004-01-01 00:00:00

  • Local cerebral glucose uptake in awake and halothane-anesthetized primates.

    abstract::Local glucose consumption within specific brain structures in awake and halothane-anesthetized primates was studied using a quantitative autoradiographic technique for glucose (14C-deoxyglucose). In both awake and anesthetized animals, significant heterogeneity (one-way analysis of variance) in uptake of glucose was f...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197802000-00004

    authors: Shapiro HM,Greenberg JH,Reivich M,Ashmead G,Sokoloff L

    更新日期:1978-02-01 00:00:00

  • Flammability of endotracheal tubes during Nd-YAG laser application in the airway.

    abstract::The effects of the neodymium-yttrium aluminum garnet (Nd-YAG) laser on several commonly used endotracheal tubes were examined. Six different types of tubes were tested for flammability. Three tubes were clear, transparent polyvinylchloride with black lettering on the surface. One was yellow-green silicone rubber with ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198611000-00010

    authors: Geffin B,Shapshay SM,Bellack GS,Hobin K,Setzer SE

    更新日期:1986-11-01 00:00:00

  • Reaginic antibodies to drugs used in anesthesia.

    abstract::Twenty-four patients survived life-threatening clinical anaphylaxis due to anesthesia. In each case the diagnosis of anaphylaxis was confirmed and the responsible drug was found by intradermal testing. To determine whether the reactions were anaphylactic or anaphylactoid, serum from each patient was tested for reagini...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198004000-00006

    authors: Fisher MM

    更新日期:1980-04-01 00:00:00

  • Barbiturate anesthetics inhibit thromboxane-, potassium-, but not angiotensin-induced pulmonary vasoconstriction.

    abstract::Administration of the oxidant lipid peroxide tertiary butyl hydroperoxide (t-bu-OOH) in the isolated rabbit lung leads to acute pulmonary vasoconstriction, which is caused by the synthesis of thromboxane. The inhalational anesthetics, halothane, nitrous oxide, and cyclopropane, markedly enhance t-bu-OOH-induced pulmon...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00012

    authors: McShane AJ,Crowley K,Shayevitz JR,Michael JR,Adkinson NF Jr,Traystman RJ,Gurtner GH

    更新日期:1989-05-01 00:00:00

  • The extent of metabolism of inhaled anesthetics in humans.

    abstract::To determine the percentage of anesthetic metabolized and to assess the role of metabolism in the total elimination of inhaled anesthetics, the authors administered isoflurane, enflurane, halothane, and methoxyflurane simultaneously, for 2 h, to nine healthy patients. Total anesthetic uptake during the 2 h of washin a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198608000-00013

    authors: Carpenter RL,Eger EI 2nd,Johnson BH,Unadkat JD,Sheiner LB

    更新日期:1986-08-01 00:00:00

  • Halothane and enflurane constrict canine mesenteric arteries by releasing Ca2+ from intracellular Ca2+ stores.

    abstract:BACKGROUND:Recent studies suggest that volatile anesthetics cause not only vasodilation but also vasoconstriction, depending on the experimental conditions. However, the mechanism of the constrictive effect of volatile anesthetics has not been clarified. The aim of this study was to evaluate the vasoconstrictor effects...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199405000-00021

    authors: Kakuyama M,Hatano Y,Nakamura K,Toda H,Terasako K,Nishiwada M,Mori K

    更新日期:1994-05-01 00:00:00

  • Site of hemodynamic effects of intrathecal alpha 2-adrenergic agonists.

    abstract::Intrathecally administered alpha 2-adrenergic agonists produce analgesia in humans but may also produce hypotension and bradycardia. To further characterize hemodynamic depression produced by intrathecally administered alpha 2-adrenergic agonists, clonidine (100-1,500 micrograms) was injected into the cervical, thorac...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199104000-00021

    authors: Eisenach JC,Tong CY

    更新日期:1991-04-01 00:00:00

  • Effect of low-dose droperidol on the QT interval during and after general anesthesia: a placebo-controlled study.

    abstract:BACKGROUND:Since the effects of antiemetic doses of droperidol on the QT interval have not been previously studied, the authors designed a randomized, double-blind, placebo-controlled study to evaluate the intraoperative and postoperative effects of small-dose droperidol (0.625 and 1.25 mg intravenous) on the QT interv...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200506000-00007

    authors: White PF,Song D,Abrao J,Klein KW,Navarette B

    更新日期:2005-06-01 00:00:00

  • Effects of intramuscular clonidine on hemodynamic and plasma beta-endorphin responses to gynecologic laparoscopy.

    abstract::Ninety women undergoing gynecologic laparoscopy were randomly given clonidine 3 or 4.5 micrograms/kg or saline intramuscularly 45-60 min prior to induction of anesthesia. Anesthesia was induced with thiopental 3.5 mg/kg and maintained with 0.3% end-tidal isoflurane in nitrous oxide and oxygen. The laparoscopy did not ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199005000-00004

    authors: Aho M,Lehtinen AM,Laatikainen T,Korttila K

    更新日期:1990-05-01 00:00:00

  • Ultra-long-duration local anesthesia produced by injection of lecithin-coated methoxyflurane microdroplets.

    abstract::This study was designed to evaluate a new drug delivery system. The authors undertook to determine if microdroplets prepared by encapsulating volatile anesthetics with a membrane of lecithin could be used for local anesthesia. Local anesthesia was determined by monitoring the response of the rat to tail clamping and e...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198511000-00004

    authors: Haynes DH,Kirkpatrick AF

    更新日期:1985-11-01 00:00:00

  • Free Fatty Acid Receptor G-protein-coupled Receptor 40 Mediates Lipid Emulsion-induced Cardioprotection.

    abstract:BACKGROUND:We have previously shown that intralipid (lipid emulsion) protects the heart against ischemia/reperfusion injury and bupivacaine-induced cardiotoxicity. However, the precise underlying mechanisms are not fully understood. Here we explored the hypothesis that free fatty acid receptor-1 or G-protein-coupled re...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002195

    authors: Umar S,Li J,Hannabass K,Vaillancourt M,Cunningham CM,Moazeni S,Mahajan A,Eghbali M

    更新日期:2018-07-01 00:00:00

  • Antinociception by spinal and systemic oxycodone: why does the route make a difference? In vitro and in vivo studies in rats.

    abstract:BACKGROUND:The pharmacology of oxycodone is poorly understood despite its growing clinical use. The discrepancy between its good clinical effectiveness after systemic administration and the loss of potency after spinal administration led the authors to study the pharmacodynamic effects of oxycodone and its metabolites ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200610000-00027

    authors: Lemberg KK,Kontinen VK,Siiskonen AO,Viljakka KM,Yli-Kauhaluoma JT,Korpi ER,Kalso EA

    更新日期:2006-10-01 00:00:00

  • Endothelial glycocalyx as an additional barrier determining extravasation of 6% hydroxyethyl starch or 5% albumin solutions in the coronary vascular bed.

    abstract:BACKGROUND:The impact on the endothelial glycocalyx for the extravasation of colloidal infusion solutions has not been investigated sufficiently. METHODS:Isolated guinea pig hearts were perfused with Krebs-Henseleit buffer in a Langendorff mode. Solutions of 0.9% saline, 5% albumin (70 kd), or 6% hydroxyethyl starch (...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200405000-00025

    authors: Rehm M,Zahler S,Lötsch M,Welsch U,Conzen P,Jacob M,Becker BF

    更新日期:2004-05-01 00:00:00

  • Addition of sodium bicarbonate to lidocaine decreases the duration of peripheral nerve block in the rat.

    abstract:BACKGROUND:Adding sodium bicarbonate to lidocaine to enhance its efficacy during peripheral nerve block is controversial. The authors studied the effect of adding sodium bicarbonate to lidocaine with and without epinephrine versus equivalent alkalinization by sodium hydroxide (NaOH) on onset, degree, and duration of pe...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200010000-00028

    authors: Sinnott CJ,Garfield JM,Thalhammer JG,Strichartz GR

    更新日期:2000-10-01 00:00:00

  • Isoflurane prevents delayed cell death in an organotypic slice culture model of cerebral ischemia.

    abstract:BACKGROUND:General anesthetics reduce neuronal death caused by focal cerebral ischemia in rodents and by in vitro ischemia in cultured neurons and brain slices. However, in intact animals, the protective effect may enhance neuronal survival for only several days after an ischemic injury, possibly because anesthetics pr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200201000-00033

    authors: Sullivan BL,Leu D,Taylor DM,Fahlman CS,Bickler PE

    更新日期:2002-01-01 00:00:00

  • Alterations in the functional connectivity of frontal lobe networks preceding emergence delirium in children.

    abstract:BACKGROUND:This study aimed to characterize the electroencephalogram in children who emerged with emergence delirium (ED) compared with children without ED using methods that involved the assessment of cortical functional connectivity. METHODS:Children aged 5 to 15 yr had multichannel electroencephalographic recording...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000376

    authors: Martin JC,Liley DT,Harvey AS,Kuhlmann L,Sleigh JW,Davidson AJ

    更新日期:2014-10-01 00:00:00

  • Comparative hemodynamic depression of sevoflurane versus halothane in infants: an echocardiographic study.

    abstract:BACKGROUND:The cardiovascular side effects of volatile anesthetics are one of the chief causes of postoperative complications in children, and infants seem to be at the greatest risk for this. This study compared cardiovascular changes at equipotent concentrations of sevoflurane and halothane in infants. METHODS:Thirt...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199710000-00012

    authors: Wodey E,Pladys P,Copin C,Lucas MM,Chaumont A,Carre P,Lelong B,Azzis O,Ecoffey C

    更新日期:1997-10-01 00:00:00

  • Radiologic localization of the laryngeal mask airway in children.

    abstract::In the absence of data on the anatomic localization of the cuff of the laryngeal mask airway (LMA) in children, radiologic images were obtained from 50 infants and children (aged 1 month to 15 yr) undergoing diagnostic radiologic procedures during halothane and N2O:O2 anesthesia. In 46 patients, the cuff of the LMA wa...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199212000-00007

    authors: Goudsouzian NG,Denman W,Cleveland R,Shorten G

    更新日期:1992-12-01 00:00:00