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., 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, 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;120(3):525-536. https://doi.org/10.1016/j.bja.2017.11.072


BibTeX

@article{822b33fc007c448499188a2ce09d8cfe,
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 (C50) 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 step-up/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{\circledR}.RESULTS: For propofol, the C50 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.CLINICAL TRIAL REGISTRATION: NCT 02043938.",
keywords = "Adolescent, Adult, Aged, Analgesics, Opioid/pharmacology, Anesthesia Recovery Period, Anesthesia, General/methods, Anesthetics, Inhalation/pharmacology, Anesthetics, Intravenous/pharmacology, Consciousness/drug effects, Cross-Over Studies, Drug Interactions, Female, Humans, Male, Middle Aged, Propofol/pharmacology, Reference Values, Remifentanil/pharmacology, Sevoflurane/pharmacology, Time Factors, Young Adult",
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}",
note = "Copyright {\circledC} 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.",
year = "2018",
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

N1 - Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

PY - 2018

Y1 - 2018

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 (C50) 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 step-up/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®.RESULTS: For propofol, the C50 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.CLINICAL TRIAL REGISTRATION: NCT 02043938.

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 (C50) 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 step-up/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®.RESULTS: For propofol, the C50 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.CLINICAL TRIAL REGISTRATION: NCT 02043938.

KW - Adolescent

KW - Adult

KW - Aged

KW - Analgesics, Opioid/pharmacology

KW - Anesthesia Recovery Period

KW - Anesthesia, General/methods

KW - Anesthetics, Inhalation/pharmacology

KW - Anesthetics, Intravenous/pharmacology

KW - Consciousness/drug effects

KW - Cross-Over Studies

KW - Drug Interactions

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Propofol/pharmacology

KW - Reference Values

KW - Remifentanil/pharmacology

KW - Sevoflurane/pharmacology

KW - Time Factors

KW - Young Adult

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: 81647030