Evaluation of the aepEX (TM) TM monitor of hypnotic depth in pediatric patients receiving propofol-remifentanil anesthesia

Yuen Cheung, G.P. Scoones, Sanne Hoeks, Robert jan Stolker, Frank Weber

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Background: The aepEX Plus monitor (aepEX) utilizes a mid-latency auditory evoked potential-derived index of depth of hypnosis (DoH). Objective: This observational study evaluates the performance of the aepEX as a DoH monitor for pediatric patients receiving propofol-remifentanil anesthesia. Methods: aepEX and BIS values were recorded simultaneously during surgery in three groups of 25 children (aged 1-3, 3-6 and 6-16 years). Propofol was administered by target-controlled infusion. The University of Michigan Sedation Scale (UMSS) was used to clinically assess the DoH during emergence. Prediction probability (Pk) and receiver operating characteristics (ROC) analyses were performed to assess the accuracy of both DoH monitors. Nonlinear regression analysis was used to describe the dose Results: The Pk for the aepEX and BIS was 0.36 and 0.21, respectively (P = 0.010). ROC analysis showed an area under the curve of 0.77 and 0.88 for the aepEX and BIS, respectively (P = 0.644). At half-maximal effect (EC50), Cp of 3.13 lg.ml(-1) and 3.06 lg.ml(-1) were observed for the aepEX and BIS, respectively. The r(2) for the aepEX and BIS was 0.53 and 0.82, respectively. Conclusion: The aepEX performs comparable to the BIS in differentiating between consciousness and unconsciousness, while performing inferior to the BIS in terms of distinguishing different levels of sedation and does not correlate well with the Cp in children receiving propofol-remifentanil anesthesia.
Original languageUndefined/Unknown
Pages (from-to)891-897
Number of pages7
JournalPaediatric Anaesthesia
Issue number10
Publication statusPublished - 2013

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  • EMC COEUR-09

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