In this study comparing the Bispectral index (BIS) in infants and children undergoing circumcision surgery by use of a standardized surgical and anesthetic technique, a significant decrease in BIS was detected in children during a stepwise decrease in end-tidal sevoflurane concentration. A similar relationship was not demonstrated in infants less than 1 yr old. In both children and infants, BIS increased significantly from pre- to postarousal. Additional studies are necessary to determine changes in BIS with maturational changes in the electroencephalogram.
Study design: A prospective double blind cross over trial of intravenous 4-Aminopyridine (4-AP). Objective: To determine the ecacy of this drug in the treatment of spinal cord injured (SCI) patients for neurologic impairment, pain and spasticity. Setting: The post anesthesia care unit (PACU) of a tertiary care acute hospital. Methods: Twelve paraplegic patients were enrolled in a double blind cross over intravenous trial of 4-Aminopyridine (4-AP). Thirty milligrams of 4-AP or placebo were administered over a 2 h period. Patients were serially examined during and after the infusion clinically for pain, sensorimotor function, hypertonicity and motor control using electromyography (EMG). Samples of blood and cerebrospinal¯uid (CSF) were also analyzed at similar intervals. Results: Despite penetration of 4-AP into the CSF, no signi®cant dierences were noted in the clinical and EMG parameters at the times measured. Individual changes in sensory function were reported by some patients in both the placebo and 4-AP trials, however mean values were not robust. Frequently, patients complained of unpleasant symptoms during the 4-AP infusion. Conclusion: The intravenous route may not be the best way to administer this drug as no short term bene®ts were observed. Spinal Cord (2000) 38, 7 ± 15
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