Skin conductance monitoring compared with bispectral index® monitoring to assess emergence from general anaesthesia using sevoflurane and remifentanil

• Published in: British journal of anaesthesia : BJA Vol. 97; no. 2; pp. 187 - 191
• Main Authors: Ledowski, T, Paech, M.J., Storm, H, Jones, R, Schug, S.A.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2006; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Aged; anaesthesia; anaesthesia, emergence from; Anesthesia; Anesthesia, General - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics; Anesthetics, Inhalation; Anesthetics, Intravenous; Biological and medical sciences; bispectral index; Electroencephalography - methods; emergence from; Female; Galvanic Skin Response; Humans; Intubation, Intratracheal; Laryngeal Masks; Male; measurement techniques; measurement techniques, skin conductance; Medical sciences; Methyl Ethers; Middle Aged; Minor Surgical Procedures; monitoring; monitoring, bispectral index; Monitoring, Physiologic - methods; Piperidines; Reaction Time; skin conductance; monitoring, bispectral index; anaesthesia, emergence from; measurement techniques, skin conductance; Volatile compound; Human; Agonist; Fluctuations; bispectral index; μ Opioid receptor; Opiates; Narcotic analgesic; Steady state; Extubation; Remifentanil; Stress; Sevoflurane; emergence from; measurement techniques; General anesthetic; Measurement technique; Surgery; skin conductance; monitoring; Anesthesia; Skin; Sedative; Monitoring; Halogen Organic compounds; anaesthesia
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/ael119

Changes in skin conductance have previously been reported to correlate well with plasma levels of stress hormones and awakening stimuli. In this study, monitoring of skin conductance during emergence from general anaesthesia was compared with the monitoring of bispectral index (BIS).
Twenty-five patients undergoing minor elective surgery were investigated. The number of fluctuations in mean skin conductance (NFSC), BIS and haemodynamic parameters were recorded simultaneously. The performance of the monitoring devices to predict and distinguish between the clinical states ‘steady-state anaesthesia’, ‘first reaction’ and ‘extubation’ were compared using the method of prediction probability (PK) calculation.
Both monitors showed similar performance in distinguishing between ‘steady-state anaesthesia’ vs ‘first reaction’ (PK NFSC 0.89; BIS® 0.94) and ‘steady-state anaesthesia’ vs ‘extubation’ (PK NFSC 0.96; BIS® 0.96). The response times of the monitors, to indicate the likelihood of ‘first reaction’, were not significantly different.
NFSC, as a parameter of skin conductance, performed similarly to BIS in patients waking after a general anaesthetic.