IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-6-25407 Original Research Paper A study of impact of A-line AEP Monitor as a tool for predicting acceptable conditions for tracheal intubation using propofol as induction agent. Rajeev Nair Dr. Dr Bhaskar Das Dr. June 2020 9 6 01 02 ABSTRACT

Background and Objectives:– It is essential for the clinical anesthetics to know whether patients are sufficiently anaesthetized to tolerate direct Laryngoscopy and Endotracheal intubation.Because of the lack of an accurate objective method to detemine the level of general anaesthesia,under or overdosing of anesthetics may occur.Currently,several technologies and devices are avialable for determining the depth of general; anaesthesia .while some of them have already been introduced in clinical practice,evaluation of the efficacy of these devices is still ongoing.A– Line AEP monitor actively reflects the changes in the patient‘s level of consciousness by measuring the evoked responses to an acoustic stimulus. This study was done to evaluate AAI measured by the A line AEP Monitor as a predictor for endotracheal intubation conditions and compare propofol consumption between the two groups.In Group A tracheal intubation was done at AAI of 15 or lower while in Group B at loss of eyelash reflex.Material and methods:–The study was a prospective,randomised,control study, 60 ASA I and II patients scheduled for surgery under general anaesthesia were included.These patients were allocated randomly into group A and group B of 30 each.All patients were premedicated with Inj Sufentail 20 mcg.Anaesthesia was started with O2(30%) and N2O(70%) given for 3 min.Induction was done with Inj Propofol 2 mg/kg bolus and 0.5 mg/kg every 30 sec there after until AAI is of 15 is reached in Group A and till loss of eyelash reflex in Group B.Tracheal intubation was done there after and intubation response assessed and was graded clinically acceptable/not acceptable as per tthe intubation score table.No muscle relaxants were used in either group.Results:–In our study tracheal intubation was clinically acceptable in 80% in Group A and 63 % in Group B Patients.The average consumption of propofol was 3 mg/kg in Group A which was higher compared to 2.25 mg/kgin Group B.A significant fall in BP(>20%) was noticed in 67% of patients in Group A compared 40% in Group B patients. Conclusion:– We conclude that AEP monitor is a better predictor of anaesthetic state than clinical signs alone.It can be used as a guide to asses the depth of anaesthesia especially when a strong stimulus like endotracheal intubation is to be done,where clinical signs are of little help.Higher doses of Propofol is needed to achieve deep levels of anaesthesia which is asscociated with increased incidence of significant fall in blood pressure.