Document Detail


Marked reduction in bispectral index with severe bradycardia without hypotension in a diabetic patient undergoing ophthalmic surgery.
MedLine Citation:
PMID:  18685940     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 75-year-old female patient underwent right vitrectomy under total intravenous anesthesia with propofol, ketamine and fentanyl. During the surgery sudden severe bradycardia (heart rate, 33 beats per min), without hypotension, occurred, which was relatively atropine-insensitive. This event was accompanied by a marked decrease in the bispectral index (BIS), from 70 to 40, and an elevation in the suppression ratio (33). Following the initiation of an isoproterenol infusion, the BIS promptly returned to 70, along with an increase in the heart rate. At the end of surgery the patient emerged from anesthesia without neurological sequelae. Severe bradycardia during anesthesia will cause cerebral hypoperfusion and this may affect cerebral function. We conclude that a BIS monitor may be a useful tool for the detection of bradycardia-related cerebral hypoperfusion.
Authors:
Hiroshi Hashimoto; Hitomi Nakamura; Kazuyoshi Hirota
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-08-07
Journal Detail:
Title:  Journal of anesthesia     Volume:  22     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-07     Completed Date:  2009-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  300-3     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bradycardia / complications*,  physiopathology
Diabetic Retinopathy / surgery*
Electroencephalography*
Female
Humans
Intraoperative Complications* / physiopathology
Isoproterenol / therapeutic use
Sympathomimetics / therapeutic use
Vitrectomy
Chemical
Reg. No./Substance:
0/Sympathomimetics; 7683-59-2/Isoproterenol

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


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