Bispectral Index as a Guide for Titration of Propofol During Procedural Sedation Among Children

Powers, Karen S.; Nazarian, Emily; Tapyrik, Sarah A; Kohli, Susan M; Yin, H. Shonna; Jagt, Élise W. van der; Sullivan, John S.; Rubenstein, Jeffrey S.

doi:10.1542/peds.2004-1979

Cited by 118 publications

(73 citation statements)

References 30 publications

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“…In post-operative cardiac surgical children, BIS is beneficial as a continuous monitor of paediatric sedation depth (Shander and Lobel, 2005), and a score of 80-85 has been shown to indicate optimum procedural sedation (Bell et al, 2004). A BIS score of 40 in children receiving sedation for painful procedures reliably indicates adequate sedation and analgesia without significant complications (Powers et al, 2005).…”

Section: Evidence Supporting Bis Use In Critically Ill Childrenmentioning

confidence: 99%

Nurse perception of Bispectral Index monitoring as an adjunct to sedation scale assessment in the critically ill paediatric patient

Hawks

Brandon

Uhl

2013

Intensive and Critical Care Nursing

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Section: Evidence Supporting Bis Use In Critically Ill Childrenmentioning

confidence: 99%

Nurse perception of Bispectral Index monitoring as an adjunct to sedation scale assessment in the critically ill paediatric patient

Hawks

Brandon

Uhl

2013

Intensive and Critical Care Nursing

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“…When the hypnotic effects of single anesthetic agents (volatile or intravenous) are assessed with BIS technology, a surgical level of anesthesia is usually encountered between a BIS of 40 and 60. There is some controversy about the clinical usefulness of measuring anesthetic depth with processed EEGs (441,450,451,550,614), but in the absence of surgical stimulation and during the use of a single agent there is a good inverse linear relationship between the numerical BIS value and increasing anesthetic plasma concentrations. Hoshino et al (279) assessed respiratory timing and upper airway responses to decreases in nasal pressure in nine propofolanesthetized healthy subjects.…”

Section: Effects On the Acute Hypoxic Ventilatory Responsementioning

confidence: 99%

Effects of Anesthetics, Sedatives, and Opioids on Ventilatory Control

Stuth

Stucke

Zuperku

2012

Comprehensive Physiology

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This article provides a comprehensive, up to date summary of the effects of volatile, gaseous, and intravenous anesthetics and opioid agonists on ventilatory control. Emphasis is placed on data from human studies. Further mechanistic insights are provided by in vivo and in vitro data from other mammalian species. The focus is on the effects of clinically relevant agonist concentrations and studies using pharmacological, that is, supraclinical agonist concentrations are de-emphasized or excluded.

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“…Powers et al [12] administered propofol for procedural sedation. The patients in the phase 3 group received highdose propofol as a bolus (0.52 mg/kg/min), and no untoward effects in any of the children were reported.…”

Section: Data Are Presented As Means and Standard Deviationsmentioning

confidence: 99%

Is the Addition of Dexmedetomidine to a Ketamine–Propofol Combination in Pediatric Cardiac Catheterization Sedation Useful?

et al. 2012

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Pediatric patients undergoing cardiac catheterization usually need deep sedation. In this study, 60 children were randomly allocated to receive sedation with either a ketamine-propofol combination (KP group, n = 30) or a ketamine-propofol-dexmedetomidine combination (KPD group, n = 30). Both groups received 1 mg/kg of ketamine and 1 mg/kg of propofol for induction of sedation, and the KPD group received an additional 1 μg/kg of dexmedetomidine infusion during 5 min for induction of sedation and a maintenance infusion of 0.5 μg/kg/h. In both groups, 0.2 mg/kg of propofol was administered as a bolus to maintain a Ramsey sedation score (RSS) greater than 4 throughout the procedure. None of the patients in either group required intubation. In the KP group, one patient required mask ventilation. The chin-lift maneuver needed to be performed for eight patients in the KP group and one patient in the KPD group (p < 0.05). Adding dexmedetomidine to the ketamine-propofol combination decreased movement during the procedures. The heart rate in the KPD group was significantly lower after induction of sedation and throughout the procedure (p < 0.05). No significant differences in systolic blood pressure, diastolic blood pressure, or respiration rates were found between the two groups (p > 0.05). The mean recovery time was longer in the KP group (5.86 vs 3.13 min; p < 0.05). Adding dexmedetomidine to a ketamine-propofol combination led to a reduced need for airway intervention and to decreased movement during local anesthetic infiltration and throughout the procedure. The recovery time was shorter and hemodynamic stability good in the KPD group.

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Bispectral Index as a Guide for Titration of Propofol During Procedural Sedation Among Children

Abstract: The BIS monitor can be a useful monitoring guide for the titration of propofol by physicians who are competent in airway and hemodynamic management, to achieve deep sedation for children undergoing painful procedures.

Cited by 118 publications

References 30 publications

Nurse perception of Bispectral Index monitoring as an adjunct to sedation scale assessment in the critically ill paediatric patient

Nurse perception of Bispectral Index monitoring as an adjunct to sedation scale assessment in the critically ill paediatric patient

Effects of Anesthetics, Sedatives, and Opioids on Ventilatory Control

Is the Addition of Dexmedetomidine to a Ketamine–Propofol Combination in Pediatric Cardiac Catheterization Sedation Useful?

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