Publication

Test of neural inertia in humans during general anaesthesia

Kuizenga, M. H., Colin, P. J., Reyntjens, K. M. E. M., Touw, D. J., Nalbat, H., Knotnerus, F. H., Vereecke, H. E. M. & Struys, M. M. R. F., Mar-2018, In : British Journal of Anaesthesia. 120, 3, p. 525-536 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Kuizenga, M. H., Colin, P. J., Reyntjens, K. M. E. M., Touw, D. J., Nalbat, H., Knotnerus, F. H., ... Struys, M. M. R. F. (2018). Test of neural inertia in humans during general anaesthesia. British Journal of Anaesthesia, 120(3), 525-536. https://doi.org/10.1016/j.bja.2017.11.072

Author

Kuizenga, M. H. ; Colin, P. J. ; Reyntjens, K. M. E. M. ; Touw, D. J. ; Nalbat, H. ; Knotnerus, F. H. ; Vereecke, H. E. M. ; Struys, M. M. R. F. / Test of neural inertia in humans during general anaesthesia. In: British Journal of Anaesthesia. 2018 ; Vol. 120, No. 3. pp. 525-536.

Harvard

Kuizenga, MH, Colin, PJ, Reyntjens, KMEM, Touw, DJ, Nalbat, H, Knotnerus, FH, Vereecke, HEM & Struys, MMRF 2018, 'Test of neural inertia in humans during general anaesthesia' British Journal of Anaesthesia, vol. 120, no. 3, pp. 525-536. https://doi.org/10.1016/j.bja.2017.11.072

Standard

Test of neural inertia in humans during general anaesthesia. / Kuizenga, M. H.; Colin, P. J.; Reyntjens, K. M. E. M.; Touw, D. J.; Nalbat, H.; Knotnerus, F. H.; Vereecke, H. E. M.; Struys, M. M. R. F.

In: British Journal of Anaesthesia, Vol. 120, No. 3, 03.2018, p. 525-536.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Kuizenga MH, Colin PJ, Reyntjens KMEM, Touw DJ, Nalbat H, Knotnerus FH et al. Test of neural inertia in humans during general anaesthesia. British Journal of Anaesthesia. 2018 Mar;120(3):525-536. https://doi.org/10.1016/j.bja.2017.11.072


BibTeX

@article{77ae39f717da427eb8ae9fd1937b5d28,
title = "Test of neural inertia in humans during general anaesthesia",
abstract = "Background: Neural inertia is defined as the tendency of the central nervous system to resist transitions between arousal states. This phenomenon has been observed in mice and Drosophila anaesthetized with volatile anaesthetics: the effect-site concentration required to induce anaesthesia in 50{\%} of the population (C-50) was significantly higher than the effect-site concentration for 50{\%} of the population to recover from anaesthesia. We evaluated this phenomenon in humans using propofol or sevoflurane (both with or without remifentanil) as anaesthetic agents.Methods: Thirty-six healthy volunteers received four sessions of anaesthesia with different drug combinations in a stepup/step-down design. Propofol or sevoflurane was administered with or without remifentanil. Serum concentrations of propofol and remifentanil were measured from arterial blood samples. Loss and return of responsiveness (LOR-ROR), response to pain (PAIN), Patient State Index (PSI) and spectral edge frequency (SEF) were modeled with NONMEM (R).Results: For propofol, the C-50 for induction and recovery of anaesthesia was not significantly different across the different endpoints. For sevoflurane, for all endpoints except SEF, significant differences were found. For some endpoints (LOR and PAIN) the difference was significant only when sevoflurane was combined with remifentanil.Conclusions: Our results nuance earlier findings with volatile anaesthetics in mice and Drosophila. Methodological aspects of the study, such as the measured endpoint, influence the detection of neural inertia. A more thorough definition of neural inertia, with a robust methodological framework for clinical studies is required to advance our knowledge of this phenomenon.",
keywords = "anaesthesia, general, anaesthesia, inhalation, anaesthesia, intravenous, consciousness monitors, unconsciousness/drug effects, PHARMACODYNAMIC INTERACTION, BISPECTRAL INDEX, IN-VITRO, REMIFENTANIL, PROPOFOL, AROUSAL, PHARMACOKINETICS, RESPONSIVENESS, VOLUNTEERS, SLEEP",
author = "Kuizenga, {M. H.} and Colin, {P. J.} and Reyntjens, {K. M. E. M.} and Touw, {D. J.} and H. Nalbat and Knotnerus, {F. H.} and Vereecke, {H. E. M.} and Struys, {M. M. R. F.}",
year = "2018",
month = "3",
doi = "10.1016/j.bja.2017.11.072",
language = "English",
volume = "120",
pages = "525--536",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "ELSEVIER SCI LTD",
number = "3",

}

RIS

TY - JOUR

T1 - Test of neural inertia in humans during general anaesthesia

AU - Kuizenga, M. H.

AU - Colin, P. J.

AU - Reyntjens, K. M. E. M.

AU - Touw, D. J.

AU - Nalbat, H.

AU - Knotnerus, F. H.

AU - Vereecke, H. E. M.

AU - Struys, M. M. R. F.

PY - 2018/3

Y1 - 2018/3

N2 - Background: Neural inertia is defined as the tendency of the central nervous system to resist transitions between arousal states. This phenomenon has been observed in mice and Drosophila anaesthetized with volatile anaesthetics: the effect-site concentration required to induce anaesthesia in 50% of the population (C-50) was significantly higher than the effect-site concentration for 50% of the population to recover from anaesthesia. We evaluated this phenomenon in humans using propofol or sevoflurane (both with or without remifentanil) as anaesthetic agents.Methods: Thirty-six healthy volunteers received four sessions of anaesthesia with different drug combinations in a stepup/step-down design. Propofol or sevoflurane was administered with or without remifentanil. Serum concentrations of propofol and remifentanil were measured from arterial blood samples. Loss and return of responsiveness (LOR-ROR), response to pain (PAIN), Patient State Index (PSI) and spectral edge frequency (SEF) were modeled with NONMEM (R).Results: For propofol, the C-50 for induction and recovery of anaesthesia was not significantly different across the different endpoints. For sevoflurane, for all endpoints except SEF, significant differences were found. For some endpoints (LOR and PAIN) the difference was significant only when sevoflurane was combined with remifentanil.Conclusions: Our results nuance earlier findings with volatile anaesthetics in mice and Drosophila. Methodological aspects of the study, such as the measured endpoint, influence the detection of neural inertia. A more thorough definition of neural inertia, with a robust methodological framework for clinical studies is required to advance our knowledge of this phenomenon.

AB - Background: Neural inertia is defined as the tendency of the central nervous system to resist transitions between arousal states. This phenomenon has been observed in mice and Drosophila anaesthetized with volatile anaesthetics: the effect-site concentration required to induce anaesthesia in 50% of the population (C-50) was significantly higher than the effect-site concentration for 50% of the population to recover from anaesthesia. We evaluated this phenomenon in humans using propofol or sevoflurane (both with or without remifentanil) as anaesthetic agents.Methods: Thirty-six healthy volunteers received four sessions of anaesthesia with different drug combinations in a stepup/step-down design. Propofol or sevoflurane was administered with or without remifentanil. Serum concentrations of propofol and remifentanil were measured from arterial blood samples. Loss and return of responsiveness (LOR-ROR), response to pain (PAIN), Patient State Index (PSI) and spectral edge frequency (SEF) were modeled with NONMEM (R).Results: For propofol, the C-50 for induction and recovery of anaesthesia was not significantly different across the different endpoints. For sevoflurane, for all endpoints except SEF, significant differences were found. For some endpoints (LOR and PAIN) the difference was significant only when sevoflurane was combined with remifentanil.Conclusions: Our results nuance earlier findings with volatile anaesthetics in mice and Drosophila. Methodological aspects of the study, such as the measured endpoint, influence the detection of neural inertia. A more thorough definition of neural inertia, with a robust methodological framework for clinical studies is required to advance our knowledge of this phenomenon.

KW - anaesthesia, general

KW - anaesthesia, inhalation

KW - anaesthesia, intravenous

KW - consciousness monitors

KW - unconsciousness/drug effects

KW - PHARMACODYNAMIC INTERACTION

KW - BISPECTRAL INDEX

KW - IN-VITRO

KW - REMIFENTANIL

KW - PROPOFOL

KW - AROUSAL

KW - PHARMACOKINETICS

KW - RESPONSIVENESS

KW - VOLUNTEERS

KW - SLEEP

U2 - 10.1016/j.bja.2017.11.072

DO - 10.1016/j.bja.2017.11.072

M3 - Article

VL - 120

SP - 525

EP - 536

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 3

ER -

ID: 63813373