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The Patient State Index (PSI) is measured using the SedLine Sedation Monitor (SedLine; Masimo Corporation) proprietary equipment and represents a numerical value of anesthesia depth. However, no study has examined PSI values for moderate sedation. We conducted a case-series study to investigate PSI values during moderate intravenous (IV) sedation for dental treatment. This pilot study was approved by the ethics committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University

/89 mm Hg, heart rate 67 beats/min, and oxygen saturation (SpO 2 ) 99%. In addition to the routine anesthetic monitoring, an EEG-based depth of anesthesia monitor (SedLine; Masimo Corporation) was applied to avoid excessive anesthetic depth and to confirm emergence from general anesthesia. A neuromuscular monitor was also applied to optimize and guide the use of nondepolarizing neuromuscular blockers throughout the case. After establishing peripheral venous access, general anesthesia was induced with propofol 100 mg, remifentanil continuous infusion 0.3 μg/kg/min, and

electroencephalography monitor (SedLine, Masimo) were placed, and a 22-gauge peripheral intravenous (IV) catheter was placed into the dorsum of the left hand. Following preoxygenation, general anesthesia was induced with a continuous IV infusion of remifentanil 0.3 μg/kg/min, propofol target-controlled infusion at 5 μg/mL, and an IV bolus of rocuronium 10 mg. After adequate mask ventilation was confirmed, an additional dose of rocuronium 20 mg was administered, and tracheal intubation with a standard-shaped ETT with a spiral-wound reinforcing wire (Shiley, Medtronic) was attempted

electrocardiography, and either a BIS (BIS View A-300, Aspect, Inc) or PSI monitor (SedLine2, Masimo, Inc). Items were measured at each point according to the protocol sheet ( Figures 1 and 2 ). Figure 1. Propofol Protocol Protocol of induction and maintenance of anesthesia with propofol. ① Baseline; ② Loss of consciousness; ③ Immediately after intubation; ④ Time out; ⑤ 1 minute after local anesthesia; ⑥ 10 minutes after the start of surgery; ⑦ End of surgery; ⑧ Immediately before extubation; ⑨ Before leaving the OR