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Use Of an Anesthesia Information Management System (AIMS) To Evaluate The Physiologic Effects Of Hypnotic Agents Used To Induce Anesthesia

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Abstract

Objective.The aim of this study was to utilize an anesthesiainformation management system (AIMS) in investigating the effects of hypnoticagents used to induce anesthesia on blood pressure, heart rate and arterialoxygen saturation. The characteristics of these agents, known from previousstudies, were compared to the effects documented in this study during routineclinical use. Methods.During the years 1997 and 1998, all relevantdata from anesthetic procedures were recorded online using the automatedanesthesia information system NarkoData. The data from 8,078 generalanesthesia procedures using endotracheal intubation were exported via“structured query language” (SQL) from the AIMS database into astatistics program after excluding children (age < 14), patients whoreceived atropine during induction and procedures with use of extracorporealcirculation. The effects of drug administration on systolic, diastolic andmean arterial blood pressure (SBP, DBP, MBP), heart rate (HR) and arterialoxygen saturation (SpO2) were analyzed prior to induction and at5, 10 and 15 minutes following bolus administration of the hypnotic agent. Thedata were classified into three groups based on the induction agent used:thiopental, etomidate or propofol and further separated into two groups basedon ASA status (ASA ≤ II and ASA > II). The mean and standard deviationswere calculated for each parameter at each point in time. Statisticalcomparisons were performed to determine whether the results for each timepoint differed from the previous time point. Results.There was asignificant decrease in blood pressure (MAP, SBP, DBP) after bolusadministration of all three hypnotics in all of the 8,078 procedures analyzed.The decrease was greater in patients of ASA class > II than in those of ASAclass ≤ II. Propofol caused the greatest drop in blood pressure whereasetomidate caused the least. During the observation period the HR also fell ineach group, except for thiopental where an initial rise of the HR could beobserved. An initial rise of SpO2 was recorded in each group withno differences observed between the individual hypnotics. Conclusions.The effects of the induction hypnotic agents thiopental, etomidate andpropofol on blood pressure and heart rate as documented by an AIMScorresponded to those found in clinical studies. An AIMS with thecorresponding documentation, software and database structure is suitable forcollecting and evaluating data for clinical investigations.

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Benson, M., Junger, A., Fuchs, C. et al. Use Of an Anesthesia Information Management System (AIMS) To Evaluate The Physiologic Effects Of Hypnotic Agents Used To Induce Anesthesia. J Clin Monit Comput 16, 183–190 (2000). https://doi.org/10.1023/A:1009937510028

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