Document Detail

BIS response to tamponade and dobutamine in swine varies with hypnotic/opiate ratio.
MedLine Citation:
PMID:  19577409     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study in swine assessed BIS stability in response to decreases and increases in cardiac output under two propofol/remifentanil dosage combinations, both producing the same depth of surgical anaesthesia. METHODS: Eight anaesthetized-paralyzed ventilated adult swine were studied using a random-order cross-over design. Four received a P low/R high combination (P, 8.4+/-0.9 mg/kg/h; and R, 0.54+/-0.02 microg/kg/min) and then a P high/R low combination (P, 26.7+/-2.1mg/kg/h; and R, 0.34+/-0.01 microg/kg/min). The other four had these two combinations in the reverse order. Under each P/R combination, and after a 60-minutes steady state, a 15-minute stable cardiac tamponade was induced by intrapericardial gelatine infusion. Then, after returning to pre tamponade condition, a 15 minutes period with dobutamine was allowed. RESULTS: Tamponade induced falls in average mean arterial pressure (MAP) (from 79+/-18 to 47+/-9 mm Hg; p<0.05) and cardiac output (Qc) (from 1.90+/-0.46 l/min to 1.20+/-0.38 l/min, p<0.05). Conversely, dobutamine increased both MAP and Qc (p<0.05). During each type of hemodynamic challenges, changes in anaesthesia depth as assessed by BIS differed dramatically between the two drug combinations, despite observing the same percent change in P and R effect-site concentration. With P high/R low and tamponade, BIS fell from 65+/-5 to 29+/-10 (p<0.05); dobutamine produced opposite effects. With P low/R high, in contrast, BIS was not influenced by either of the hemodynamic challenges. CONCLUSION: Conversely to a high propofol/low remifentanil combination, a low propofol/high remifentanil combination allows constant anaesthetic depth in the face of haemodynamic challenges.
L Beydon; J C Desfontis; F Ganster; J Petres; F Gautier; S Ferec; A Cailleux; C Dussaussoy; N Liu; T Chazot; M Fischler; M Gogny
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Publication Detail:
Type:  Journal Article     Date:  2009-07-03
Journal Detail:
Title:  Annales françaises d'anesthèsie et de rèanimation     Volume:  28     ISSN:  1769-6623     ISO Abbreviation:  Ann Fr Anesth Reanim     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-10-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8213275     Medline TA:  Ann Fr Anesth Reanim     Country:  France    
Other Details:
Languages:  eng     Pagination:  650-7     Citation Subset:  IM    
Pôle d'Anesthésie-Réanimation, CHU d'Angers, 49933 Angers cedex 9, France.
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MeSH Terms
Analgesics, Opioid / pharmacology*
Anesthesia, Intravenous
Anesthetics, Intravenous / pharmacology
Blood Pressure / drug effects
Cardiac Output / drug effects
Cardiac Tamponade / chemically induced*,  physiopathology*
Cardiotonic Agents / pharmacology*
Dobutamine / pharmacology*
Drug Combinations
Electroencephalography / drug effects*
Hypnotics and Sedatives / pharmacology*
Monitoring, Intraoperative
Piperidines / pharmacology
Propofol / pharmacology
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anesthetics, Intravenous; 0/Cardiotonic Agents; 0/Drug Combinations; 0/Hypnotics and Sedatives; 0/Piperidines; 132875-61-7/remifentanil; 2078-54-8/Propofol; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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