{"title":"甲状腺手术患者呼出气体中丙泊酚浓度与 BIS 之间的相关性","authors":"Xiaoxiao Li, Pan Chang, Xing Liu, Zhongjun Zhao, Yixiang Duan, Wensheng Zhang","doi":"10.1088/1752-7163/ad9496","DOIUrl":null,"url":null,"abstract":"<p><p>Several clinical studies have reported promising correlations between propofol concentration in exhaled breath (Ce-pro) and the bispectral index (BIS) in patients, suggesting the potential of exhaled propofol measurement as a non-invasive method for adjusting anesthesia depth. However, these studies are still in the validation phase of instrument effectiveness, often limited by small sample sizes or inappropriate instrument selection, and thus lack convincing results regarding these correlations. In this study, one hundred patients aged 18-65, undergoing elective thyroid surgery under general anesthesia were included. The vacuum ultraviolet (VUV) photoionization and time-of-flight mass spectrometry (TOF MS) was employed to monitor Ce-pro at 20-second intervals, alongside continuous BIS measurement. The association between Ce-pro and BIS was analyzed using linear mixed-effects models, with marginal R² used to assess the correlation. The threshold of Ce-pro at awakening was also explored. Additionally, the univariate and multifactorial diagnostic model, including end-of-surgery Ce-pro, were employed to assess the accuracy of predicting delayed recovery. A weak correlation was observed between intraoperative Ce-pro and BIS (marginal R2 = 0.348). Predictive models utilising end-of-surgery Ce-pro levels showed good accuracy (AUC = 0.75, 95% CI: 0.62 to 0.89, P = 0.003) in predicting delayed recovery, while the model using end-of-surgery Ce-pro combined with gender, sufentanil dosage, the time from the last administration of sufentanil to the end of surgery, and anesthesia duration demonstrated stronger predicting accuracy (AUC = 0.91, 95% CI: 0.85 to 0.98, P < 0.001). This study suggests that Ce-pro alone may not reliably predict the depth of anesthesia in clinical practice, but shows promising accuracy in predicting delayed recovery from anesthesia.
Clinical trial number: ChiCTR2300074605
Keywords: Propofol; Exhaled Breath; BIS; Correlation.</p>","PeriodicalId":15306,"journal":{"name":"Journal of breath research","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlations between Propofol Concentration in Exhaled Breath and BIS in Patients undergoing Thyroid Surgery.\",\"authors\":\"Xiaoxiao Li, Pan Chang, Xing Liu, Zhongjun Zhao, Yixiang Duan, Wensheng Zhang\",\"doi\":\"10.1088/1752-7163/ad9496\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Several clinical studies have reported promising correlations between propofol concentration in exhaled breath (Ce-pro) and the bispectral index (BIS) in patients, suggesting the potential of exhaled propofol measurement as a non-invasive method for adjusting anesthesia depth. However, these studies are still in the validation phase of instrument effectiveness, often limited by small sample sizes or inappropriate instrument selection, and thus lack convincing results regarding these correlations. In this study, one hundred patients aged 18-65, undergoing elective thyroid surgery under general anesthesia were included. The vacuum ultraviolet (VUV) photoionization and time-of-flight mass spectrometry (TOF MS) was employed to monitor Ce-pro at 20-second intervals, alongside continuous BIS measurement. The association between Ce-pro and BIS was analyzed using linear mixed-effects models, with marginal R² used to assess the correlation. The threshold of Ce-pro at awakening was also explored. Additionally, the univariate and multifactorial diagnostic model, including end-of-surgery Ce-pro, were employed to assess the accuracy of predicting delayed recovery. A weak correlation was observed between intraoperative Ce-pro and BIS (marginal R2 = 0.348). Predictive models utilising end-of-surgery Ce-pro levels showed good accuracy (AUC = 0.75, 95% CI: 0.62 to 0.89, P = 0.003) in predicting delayed recovery, while the model using end-of-surgery Ce-pro combined with gender, sufentanil dosage, the time from the last administration of sufentanil to the end of surgery, and anesthesia duration demonstrated stronger predicting accuracy (AUC = 0.91, 95% CI: 0.85 to 0.98, P < 0.001). This study suggests that Ce-pro alone may not reliably predict the depth of anesthesia in clinical practice, but shows promising accuracy in predicting delayed recovery from anesthesia.
Clinical trial number: ChiCTR2300074605
Keywords: Propofol; Exhaled Breath; BIS; Correlation.</p>\",\"PeriodicalId\":15306,\"journal\":{\"name\":\"Journal of breath research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of breath research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1088/1752-7163/ad9496\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"BIOCHEMICAL RESEARCH METHODS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of breath research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1088/1752-7163/ad9496","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"BIOCHEMICAL RESEARCH METHODS","Score":null,"Total":0}
Correlations between Propofol Concentration in Exhaled Breath and BIS in Patients undergoing Thyroid Surgery.
Several clinical studies have reported promising correlations between propofol concentration in exhaled breath (Ce-pro) and the bispectral index (BIS) in patients, suggesting the potential of exhaled propofol measurement as a non-invasive method for adjusting anesthesia depth. However, these studies are still in the validation phase of instrument effectiveness, often limited by small sample sizes or inappropriate instrument selection, and thus lack convincing results regarding these correlations. In this study, one hundred patients aged 18-65, undergoing elective thyroid surgery under general anesthesia were included. The vacuum ultraviolet (VUV) photoionization and time-of-flight mass spectrometry (TOF MS) was employed to monitor Ce-pro at 20-second intervals, alongside continuous BIS measurement. The association between Ce-pro and BIS was analyzed using linear mixed-effects models, with marginal R² used to assess the correlation. The threshold of Ce-pro at awakening was also explored. Additionally, the univariate and multifactorial diagnostic model, including end-of-surgery Ce-pro, were employed to assess the accuracy of predicting delayed recovery. A weak correlation was observed between intraoperative Ce-pro and BIS (marginal R2 = 0.348). Predictive models utilising end-of-surgery Ce-pro levels showed good accuracy (AUC = 0.75, 95% CI: 0.62 to 0.89, P = 0.003) in predicting delayed recovery, while the model using end-of-surgery Ce-pro combined with gender, sufentanil dosage, the time from the last administration of sufentanil to the end of surgery, and anesthesia duration demonstrated stronger predicting accuracy (AUC = 0.91, 95% CI: 0.85 to 0.98, P < 0.001). This study suggests that Ce-pro alone may not reliably predict the depth of anesthesia in clinical practice, but shows promising accuracy in predicting delayed recovery from anesthesia.
Clinical trial number: ChiCTR2300074605
Keywords: Propofol; Exhaled Breath; BIS; Correlation.
期刊介绍：
Journal of Breath Research is dedicated to all aspects of scientific breath research. The traditional focus is on analysis of volatile compounds and aerosols in exhaled breath for the investigation of exogenous exposures, metabolism, toxicology, health status and the diagnosis of disease and breath odours. The journal also welcomes other breath-related topics.
Typical areas of interest include:
Big laboratory instrumentation: describing new state-of-the-art analytical instrumentation capable of performing high-resolution discovery and targeted breath research; exploiting complex technologies drawn from other areas of biochemistry and genetics for breath research.
Engineering solutions: developing new breath sampling technologies for condensate and aerosols, for chemical and optical sensors, for extraction and sample preparation methods, for automation and standardization, and for multiplex analyses to preserve the breath matrix and facilitating analytical throughput. Measure exhaled constituents (e.g. CO2, acetone, isoprene) as markers of human presence or mitigate such contaminants in enclosed environments.
Human and animal in vivo studies: decoding the ''breath exposome'', implementing exposure and intervention studies, performing cross-sectional and case-control research, assaying immune and inflammatory response, and testing mammalian host response to infections and exogenous exposures to develop information directly applicable to systems biology. Studying inhalation toxicology; inhaled breath as a source of internal dose; resultant blood, breath and urinary biomarkers linked to inhalation pathway.
Cellular and molecular level in vitro studies.
Clinical, pharmacological and forensic applications.
Mathematical, statistical and graphical data interpretation.
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