Evidence map›Paper›PMID 41239249›Full record

ArticleBMC anesthesiology2025

Evaluating the performance of the Narcotrend

Max Ebensperger, Matthias Kreuzer, Stephan Kratzer, Darren Hight, Heiko A Kaiser, Gerhard Schneider, Stefan Schwerin

Registry-linked trialAbstract read
In one paragraph

Article in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02976584 (Incidence of Epileptic Potentials During Cardiac Surgery and Postoperative Neurological Outcome), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02976584 completednot on this map

Incidence of Epileptic Potentials During Cardiac Surgery and Postoperative Neurological Outcome: A Prospective Observational Study

TypeobservationalSponsorHeiko KaiserRan2016 to 2018Enrolled1,067ConditionsEpilepsy, Cardiac Disease, Peroperative Complications, Anesthesia
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Max EbenspergerDepartment of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Matthias KreuzerDepartment of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Stephan KratzerDepartment of Anesthesia, Intensive Care and Pain Medicine, Hessing Foundation, Augsburg, Germany.
Darren HightDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Heiko A KaiserDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Gerhard SchneiderDepartment of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Stefan SchwerinDepartment of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany. stefan.schwerin@tum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUsing neuromonitoring during general anaesthesia provides insights into the effects of anaesthetics on the brain. We focus on the performance of the processed EEG indices Narcotrend

methodsIn this single-centre retrospective study, we analysed processed electroencephalographic (EEG) data from 439 patients who underwent general anaesthesia for cardiac surgery. We employed data visualisation techniques, such as histograms and heat maps. We conducted statistical analyses using correlation coefficients, receiver operating characteristics, and linear regression to evaluate Narcotrend performance under various BSR conditions.

resultsThe NCT index demonstrated distinct "peak" values (37, 46, and 61), which occurred with a probability more than two standard deviations above the overall index distribution (BSR = 0). During steady-state anaesthesia, 70% [Q1, Q3: 67,72] of values were within the manufacturer-recommended range for adequate anaesthesia, 22% [Q1, Q3: 21,29] were below, and 8% [Q1, Q3: 6,12] were above. With the onset of BSR > 0, NCT decreased significantly (p < 0.001) but showed significant variability immediately before and after automated burst suppression detection. Approximately 13% [Q1, Q3: 9,24] of NCT readings were non-interpretable. These brief episodes increased significantly with patient age (p = 0.013) and were not attributable to concurrent burst suppression.

conclusionThe Narcotrend index remains within recommended ranges during steady-state anaesthesia in a predominantly male patient cohort undergoing cardiac surgery. However, index performance decreases with age, and the high incidence of non-interpretable readings in elderly patients highlights the need for cautious interpretation, despite their short duration. Automatically detected burst suppression (BSR > 0) leads to a near-instant decrease in NCT values, suggesting a technical link between the algorithms. "Peak" index values indicate an irregular scaling in the distribution of NCT index values.

trial registrationThis trial was retrospectively registered at ClinicalTrials.gov (NCT02976584) in October 2016.

Indexed as

Anesthesia, GeneralCardiac Surgical ProceduresElectroencephalographyMonitoring, IntraoperativeAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesAnaesthesiaBurst suppressionCardiac surgeryElectroencephalogramNarcotrendNeuromonitoring

Identifiers

PMID41239249
PMCPMC12619384

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.