Correlation between cerebral state index and end-tidal concentration of sevoflurane in children with cerebral palsy undergoing adjustment surgery

  Objective  To investigate the correlation between cerebral state index (CSI) and end-tidal concentration of sevoflurane (C_ETSev) in children with cerebral palsy during sevoflurane general anesthesia.

  Methods  Eighty children with cerebral palsy for selective lower limb adjustment surgery were selected. Sevoflurane general anesthesia and routine monitoring were performed, and C_ETSev as well as CSI were continuously monitored. Before induction (T₀), after laryngeal mask implantation (T₁), C_ETSev 0.8% (T₂), C_ETSev 1.2% (T₃), C_ETSev 1.6% (T₄), C_ETSev 2.0%(T₅), C_ETSev 2.4% (T₆), C_ETSev 2.8% (T₇), stop taking sevoflurane (T₈) and declining stages including C_ETSev 1.4% (T₉), C_ETSev 1.2%(T₁₀), C_ETSev 1.0% (T₁₁), C_ETSev 0.8% (T₁₂), C_ETSev 0.6% (T₁₃), C_ETSev 0.4% (T₁₄), before (T₁₅) and after (T₁₆) laryngeal mask removal, the values of C_ETSev and CSI were recorded. The correlation between C_ETSev and CSI introduction was analyzed.

  Results  During the rising period of C_ETSev (T₀ to T₇), the CSI of T₂ to T₇ was significantly lower than that of T₀ (P < 0.05); CSI was negatively correlated with C_ETSev (r=-0.890, P < 0.001). During the decreasing period of C_ETSev (T₈ to T₁₆), CSI values of T₉ to T₁₆ were significantly higher than that of T₈ (P < 0.05); CSI was negatively correlated with C_ETSev (r=-0.889, P < 0.001).

  Conclusion  There is a significant negative correlation between CSI and C_ETSev in the rising and descending period of C_ETSev in children with cerebral palsy undergoing palsy adjustment surgery. Therefore, CSI can be used to guide the accurate use of sevoflurane during general anesthesia.