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Thiopental-induced Burst Suppression Measured by the Bispectral Index is Extended During Propofol Administration Compared With Sevoflurane.
MedLine Citation:
PMID:  22210231     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Thiopental is used to suppress cerebral metabolism during temporary clip ligation of the cerebral arteries. Electroencephalogram (EEG) can measure intraoperative burst suppression as evidence of cerebral metabolic suppression, but EEG is not always available during clip ligation. This study was conducted to compare the effect of propofol-based total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia on thiopental-induced burst suppression during aneurysm surgery. The effect of thiopental was measured by burst suppression ratio (BSR) using the bispectral index (BIS) monitor. METHODS:: Forty-six patients who underwent temporary clipping during aneurysm surgery were randomized into 2 groups. The inhalation group (n=21) received sevoflurane-N2O anesthesia and the TIVA group (n=25) received propofol-remifenatanil-N2O anesthesia. The anesthesia level maintained a BIS value between 40 and 55. Pharmacological burst suppression was induced with bolus administration of thiopental (5 mg/kg) before temporary clipping. The BIS number, BSR values, the onset time and duration of BSR, and hemodynamic variables were recorded every minute in both groups. RESULTS:: There were no significant differences between groups in the onset time of burst suppression (P=0.394) and BIS changes (P=0.878). However, statistically significant longer duration (P<0.001) and significantly higher degree of burst suppression (P=0.006) were observed in the TIVA group compared with the inhalation group. CONCLUSIONS:: Our results suggest that at equivalent BIS values TIVA with propofol anesthesia provides longer duration and greater cerebral metabolic suppression compared with sevoflurane-N2O inhalation anesthesia. BIS may be an acceptable alternative to standard EEG monitoring when assessing burst suppression during temporary clipping.
Authors:
Jun Rho Yoon; Yee Suk Kim; Tae Kwan Kim
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-28
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  -     ISSN:  1537-1921     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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