| The effect of neuromuscular block and noxious stimulation on hypnosis monitoring during sevoflurane anesthesia. | |
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MedLine Citation:
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PMID: 17717224 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Andreas Ekman; Erik Stålberg; Eva Sundman; Lars I Eriksson; Lars Brudin; Rolf Sandin |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 105 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-24 Completed Date: 2007-09-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 688-95 Citation Subset: AIM; IM |
Affiliation:
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Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institute, Stockholm, Sweden. andrease@ltkalmar.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Androstanols / administration & dosage, pharmacology* Anesthetics, Inhalation* Brain / drug effects* Cholinesterase Inhibitors / pharmacology Consciousness / drug effects* Electric Stimulation / methods Electroencephalography Electromyography Evoked Potentials, Auditory / drug effects* Female Humans Infusions, Intravenous Male 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 |
| Chemical | |
Reg. No./Substance:
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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
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