Feasibility of Closed-Loop TCI Based on New EEG Baseline in the Presence of Low Dose of Esketamine: A Randomized Controlled Equivalence Trial.
Drug design, development and therapy January 1, 2025 Xiaoshan Li, Shengchao Li, Chanyan Xu et al. 3 citations
A low dose of esketamine (0.2 mg/kg bolus, 5 μg/kg/min infusion for 30 minutes) raised the Bispectral Index (BIS) from 49.9±4.5 to 59.6±6.0 during propofol-remifentanil general anesthesia. A closed-loop target-controlled infusion (TCI) system that adjusted its drug delivery based on this new BIS baseline performed as well as a system using the original baseline of 50, with both falling within the range of high-performance systems. The adjusted system reduced propofol consumption (5.58±1.12 vs 6.69±1.36 mg·kg⁻¹·h⁻¹) without increasing adverse events such as intraoperative awareness, postoperative pain, nausea, vomiting, or shivering. Operating the closed-loop TCI system with an adjusted BIS baseline is feasible when low-dose esketamine is used.