Document Detail


Relationship between clinical endpoints for induction of anesthesia and bispectral index and effect-site concentration values.
MedLine Citation:
PMID:  12088804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To assess the relationship between clinical endpoints for induction of anesthesia and the electroencephalographic (EEG) bispectral index (BIS) and effect-site concentration (C(E)) values when using a target-controlled infusion (TCI) of either thiopental sodium or propofol, by hypothesizing that yawning may be a useful alternative to other commonly used clinical signs for determining loss of consciousness. DESIGN: Randomized observational clinical study. SETTING: Operating room of a university-based hospital. PATIENTS: 60 healthy adult patients (aged 20-50 yrs) scheduled for elective surgery with general anesthesia. INTERVENTIONS: During a TCI of propofol (n = 30) or thiopental (n = 30), clinical endpoints for loss of verbal responsiveness (LOV), loss-of-eyelash reflex (LOE), occurrence of yawning, and apnea were assessed at 15-second intervals. In addition, BIS and C(E) values were recorded at each of the endpoints. MEASUREMENTS AND MAIN RESULTS: In both anesthetic groups, the sequence of occurrence of the clinical endpoints was similar, namely LOV, LOE, yawning, and, lastly, apnea. Compared with LOV and LOE, yawning was associated with lower BIS and higher C(E) values with both anesthetics. The frequency of yawning was higher with thiopental than propofol (83% vs. 63%, respectively). However, the frequency of apnea was higher with propofol than thiopental (77% vs. 53%, respectively). CONCLUSION: The correlation of the clinical endpoints with BIS and C(E) values was highest for LOV. Yawning was as unreliable as LOE for determining the onset of unconsciousness during induction of anesthesia. This clinical sign failed to be observed in 17% and 37% of patients induced with thiopental and propofol, respectively.
Authors:
Dae Woo Kim; Ho Yeong Kil; Paul F White
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  14     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-28     Completed Date:  2002-09-13     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  241-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, The Catholic University of Korea, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General*
Anesthetics, Intravenous / administration & dosage*
Blinking
Cognition
Electroencephalography*
Endpoint Determination*
Female
Humans
Infusion Pumps
Infusions, Intravenous
Male
Middle Aged
Propofol / administration & dosage
Thiopental / administration & dosage
Unconsciousness / diagnosis*
Yawning
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol; 76-75-5/Thiopental

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