The use of dexmedetomidine to provide analgesia/sedation for colonoscopy is limited by distressing side effects, pronounced hemodynamic instability, prolonged recovery, and a complicated administration regimen.
Most changes in HRV components occurred during colonoscopy of the left side of the bowel. Analgesia/sedation and total intravenous anesthesia increased HRV by increasing the LF component.
We describe a case in which an unexpectedly, abnormally low bispectral index value (BIS = 4) and an almost isoelectric electroencephalogram (EEG) pattern were observed during typical induction of anesthesia with propofol. Starting 2 min after the beginning of propofol administration (1.26 mg kg(-1)), the EEG recordings showed burst and suppression pattern for the next 12 min. The EEG during this period was characterized by gradual prolongation of suppression periods until the appearance of the isoelectric line. After that, burst activity returned and eventually the burst suppression pattern disappeared. We excluded the possibility of ischemic brain damage, and the evidence increasingly points toward a greater sensitivity to propofol. The findings described in this case report support the thesis that there is a wide variability in the responses of patients to propofol that cannot be detected without continuous monitoring of cortical electrical activity.
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