Document Detail


Bispectral index monitoring during balanced xenon or sevoflurane anaesthesia in elderly patients.
MedLine Citation:
PMID:  20671557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: In the elderly, monitoring depth of anaesthesia seems to be of particular importance. We evaluated the bispectral index (BIS) for monitoring depth of anaesthesia during clinically guided balanced xenon or sevoflurane anaesthesia in aged patients.
METHODS: In this randomized controlled clinical trial, 40 patients (65-75 years) undergoing elective noncardiac surgery were randomly assigned to balanced anaesthesia with either 53.2 +/- 0.8% xenon (n = 19) or 1.6 +/- 0.1% sevoflurane (n = 20) in minimum 30% oxygen and remifentanil titrated to clinical needs. Depth of anaesthesia was guided by end-tidal gas concentrations and clinical signs. The attending anaesthesiologist was blinded to the BIS values, which were recorded at 1 min rates during induction, at 5 min rates during maintenance and at 20 s rates during emergence. Emergence from anaesthesia was assessed by the times to open eyes, react on demand, extubation and orientation.
RESULTS: During induction and maintenance of anaesthesia, BIS values in the xenon group were comparable to sevoflurane and at the lower limit of the recommended range for deep anaesthesia. Emergence to full orientation was significantly faster from xenon than from sevoflurane. BIS values were significantly lower during emergence from xenon anaesthesia.
CONCLUSION: During xenon and sevoflurane anaesthesia in the elderly, BIS-values show sufficient concordance with clinical signs of anaesthetic depth. Since during clinically guided anaesthesia values were at the lower recommended limit, additional BIS monitoring may help reduce anaesthetic consumption and costs.
Authors:
Astrid V Fahlenkamp; Franziska Krebber; Steffen Rex; Oliver Grottke; Michael Fries; Rolf Rossaint; Mark Coburn
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  27     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  906-11     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University Hospital Aachen of the RWTH Aachen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia Recovery Period
Anesthetics, Inhalation / pharmacology*
Consciousness Monitors*
Double-Blind Method
Female
Humans
Male
Methyl Ethers / pharmacology*
Single-Blind Method
Surgical Procedures, Elective / methods
Time Factors
Xenon / pharmacology*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane; 7440-63-3/Xenon

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


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