Document Detail

The effect of neuromuscular block and noxious stimulation on hypnosis monitoring during sevoflurane anesthesia.
MedLine Citation:
PMID:  17717224     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There are conflicting results on the influence of neuromuscular block (NMB) on the bispectral index (BIS). We investigated the influence of two degrees of NMB on BIS, Alaris auditory-evoked potential index (AAI), and the electromyogram (EMG) obtained with needle electrodes from the frontal and temporal muscles, immediately adjacent to the BIS-sensor. METHODS: Twenty patients were anesthetized with sevoflurane, titrated for 30 min to an end-tidal concentration of 1.2% (baseline). Rocuronium was infused to 50% (partial) and 95% (profound) depression of the first twitch in a train-of-four response, the order being randomly chosen. Noxious tetanic electrical stimulation was applied at four occasions: 1) at baseline (control measurement), 2 and 3) at each degree of NMB, and 4) after neostigmine reversal. BIS, AAI, and EMG were obtained 2 min before and 2 min after each noxious stimulation. RESULTS: Median BIS and AAI at baseline were 44 (39-50) and 15 (14-16), respectively. The two degrees of NMB did not affect BIS, AAI, and EMG before noxious stimulation. In contrast, profound NMB altered the BIS and AAI responses to noxious stimulation when compared with partial NMB, (BIS P = 0.01, AAI P < 0.01), after neostigmine reversal (BIS P < 0.01, AAI P = 0.01) and compared with baseline (BIS P = 0.08, AAI P = 0.02). No significant increase in EMG was found. CONCLUSION: BIS and AAI responses to noxious tetanic electrical stimulation are affected by the degree of NMB during sevoflurane anesthesia whereas NMB does not affect BIS or AAI in the absence of noxious stimulation.
Andreas Ekman; Erik Stålberg; Eva Sundman; Lars I Eriksson; Lars Brudin; Rolf Sandin
Related Documents :
2883794 - Positive effects of ketamine v. metomidate anesthesia on cardiovascular function, oxyge...
17312214 - Hypercapnic hyperventilation shortens emergence time from isoflurane anesthesia.
23667004 - Tendon response in achilles tendon of australian football players using ultrasound tiss...
24755094 - Exercise reduces diet-induced cognitive decline and increases hippocampal brain-derived...
24548114 - A randomized controlled trial of aspirin and exertional heat stress activation of plate...
20138384 - Prescription of physical activity is not sufficient to change sedentary behavior and im...
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-24     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  688-95     Citation Subset:  AIM; IM    
Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institute, Stockholm, Sweden.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Androstanols / administration & dosage,  pharmacology*
Anesthetics, Inhalation*
Brain / drug effects*
Cholinesterase Inhibitors / pharmacology
Consciousness / drug effects*
Electric Stimulation / methods
Evoked Potentials, Auditory / drug effects*
Infusions, Intravenous
Mental Recall / drug effects
Methyl Ethers*
Middle Aged
Monitoring, Intraoperative / methods
Neostigmine / pharmacology
Neuromuscular Nondepolarizing Agents / administration & dosage,  pharmacology*
Pain Threshold / drug effects*
Prospective Studies
Research Design
Time Factors
Ulnar Nerve
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Inhalation; 0/Cholinesterase Inhibitors; 0/Methyl Ethers; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium; 28523-86-6/sevoflurane; 59-99-4/Neostigmine

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

Previous Document:  Measurement of anesthetics in blood using a conventional infrared clinical gas analyzer.
Next Document:  Exhaled carbon monoxide levels change in relation to inspired oxygen fraction during general anesthe...