Bispectral Index and Hemodynamic and Catecholamine Responses to Intubation during Target-Effect Site-Controlled Infusion of Propofol with Fentanyl Coadministration.
10.4097/kjae.2005.49.1.40
- Author:
Hee Jung BAIK
1
;
Yun Jin KIM
;
Jong Hak KIM
Author Information
1. Department of Anesthesiology, College of Medicine, Ewha Womans University, Seoul, Korea. baikhj@ewha.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
bispectral index;
catecholamine;
effect site-controlled infusion;
fentanyl;
hemodynamic response;
propofol
- MeSH:
Anesthesia;
Anesthesia, General;
Arterial Pressure;
Epinephrine;
Fentanyl*;
Heart Rate;
Hemodynamics*;
Humans;
Intubation*;
Norepinephrine;
Propofol*;
Unconsciousness
- From:Korean Journal of Anesthesiology
2005;49(1):40-46
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We evaluated bispectral index (BIS) and hemodynamic and catecholamine responses to induction and intubation at different effect site concentrations during the target-effect site-controlled infusion of propofol with fentanyl coadministration. METHODS: Thirty patients scheduled for elective surgery under general anesthesia were randomly assigned to two groups. Anesthesia was induced using the target-effect site-controlled infusion of propofol at different effect site concentrations (Group I: 3.0microgram/ml, Group II: 3.5microgram/ml) following bolus injection of fentanyl (2microgram/kg). We measured BIS and systolic, diastolic, and mean arterial blood pressures, heart rate, epinephrine (E), and norepinephrine (NE) 5 min before induction, at loss of consciousness, just before intubation, immediately after intubation, and 1, 2, and 3 minutes after intubation. RESULTS: No significant differences were observed in hemodynamic or catecholamine responses to induction or intubation between the two groups. In both groups, hemodynamic changes to induction and intubation were within 30% and 20% of pre-induction levels, respectively, and catecholamine responses significantly decreased or did not change versus pre-induction levels. But in group II, the dose of propofol administered was significantly more than in group I, and BIS levels immediately before and after intubation were below 40. CONCLUSIONS: With fentanyl coadministration of 2microgram/kg, targeting 3.0microgram/ml as an effect site concentration of propofol during target-effect site-controlled infusion is better than targeting 3.5microgram/ml, because targeting the latter produced too low a BIS and too much propofol administration, although both targeted values produced similar hemodynamic and catecholamine responses.
