Document Detail


Comparative effects of ketamine on Bispectral Index and spectral entropy of the electroencephalogram under sevoflurane anaesthesia.
MedLine Citation:
PMID:  15591328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Bispectral Index (BIS) and spectral entropy of the electroencephalogram can be used to assess the depth of hypnosis. Ketamine is known to increase BIS in anaesthetized patients and may confound that index as a guide to steer administration of hypnotics. We compared the effects of ketamine on BIS, response entropy (RE) and state entropy (SE) during surgery under sevoflurane anaesthesia. METHODS: Twenty-two women undergoing gynaecological surgery were enrolled in this double-blind, randomized study. Anaesthesia was induced i.v. and maintained with sevoflurane. Under stable surgical and anaesthetic conditions, patients were assigned to receive either a bolus of ketamine 0.5 mg kg(-1) or the same volume of saline. Blood pressure, heart rate, BIS, RE and SE were measured every 2.5 min from 10 min before (baseline) until 15 min after ketamine or saline administration. The maximum relative increase in BIS, RE and SE compared with baseline was calculated for each patient. Values are mean (sd). RESULTS: Baseline values were BIS 33 (4), RE 31 (5), SE 30 (5) for the ketamine patients and BIS 35 (3), RE 33 (5) and SE 32 (6) for the patients receiving saline. BIS, RE and SE increased significantly from 5 min (BIS) and 2.5 min (RE and SE) after ketamine administration, peaking at 46 (8) (BIS), 52 (12) (RE) and 50 (12) (SE) respectively. The maximum relative increase in RE [42.2 (10.4%)] and SE [41.6 (10.9)%] was higher than that of BIS [29.4 (10.4%)]. Blood pressure, heart rate and RE-SE gradient did not change in either group. CONCLUSIONS: Ketamine administered under sevoflurane anaesthesia causes a significant increase in BIS, RE and SE without modification of the RE-SE gradient. This increase is paradoxical in that it is associated with a deepening level of hypnosis.
Authors:
P Hans; P-Y Dewandre; J F Brichant; V Bonhomme
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2004-12-10
Journal Detail:
Title:  British journal of anaesthesia     Volume:  94     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-10     Completed Date:  2005-03-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
Affiliation:
CHR Citadelle, University Department of Anaesthesia and Intensive Care Medicine, Liège, Belgium. pol.hans@chu.ulg.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthetics, Combined / pharmacology
Anesthetics, Dissociative / pharmacology*
Anesthetics, Inhalation / pharmacology*
Blood Pressure / drug effects
Double-Blind Method
Electroencephalography / drug effects*
Entropy
Female
Gynecologic Surgical Procedures
Heart Rate / drug effects
Humans
Ketamine / pharmacology*
Methyl Ethers / pharmacology*
Middle Aged
Monitoring, Intraoperative / methods
Signal Processing, Computer-Assisted
Chemical
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Dissociative; 0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane; 6740-88-1/Ketamine

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


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