Epidural Lidocaine Decreases Sevoflurane Requirement for Adequate Depth of Anesthesia as Measured by the Bispectral Index ®  Monitor

Hodgson, Peter S.; Liu, Spencer S.

doi:10.1097/00000542-200105000-00018

Cited by 159 publications

(100 citation statements)

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“…However, it is interesting to note that intravenous lidocaine also failed to reduce volatile anesthetic requirements titrated to BIS in a study directly comparing intravenous and epidural administration of lidocaine. 9 Despite similar serum concentrations of lidocaine (2 lgÁmL -1 ) following both intravenous and epidural administration, only those patients given lidocaine in their epidurals showed evidence of anesthetic sparing. Previous research demonstrates that volatile anesthetics exert their immobilizing effect at the spinal level.…”

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy

Bryson

Charapov

Krolczyk

et al. 2010

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy

Bryson

Charapov

Krolczyk

et al. 2010

Can J Anesth/J Can Anesth

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“…15 However, unlike the previous investigation by Ahmad et al, 6 the end-tidal sevoflurane concentrations in this study were compatible with BIS values in the range of 50 to 60. 2,16 The failure to demonstrate significant differences in recovery times between the two study groups was likely multifactorial. Firstly, the impact of a cerebral monitor in improving the titration of the maintenance anesthetic will be minimized when the device is used for relatively brief surgical procedures (28-31 min).…”

Section: Discussionmentioning

confidence: 99%

Bispectral index monitoring does not improve early recovery of geriatric outpatients undergoing brief surgical procedures

Zohar

Luban

White

et al. 2006

Can J Anesth/J Can Anesth

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Purpose:To assess if titration of sevoflurane using the bispectral index (BIS) monitor improves the early and intermediate recovery in geriatric outpatients undergoing brief urologic procedures under general anesthesia without muscle relaxants. Methods:After a standardized induction with propofol and fentanyl, a laryngeal mask airway was inserted and sevoflurane was administered in combination with 60% nitrous oxide in oxygen for maintenance of anesthesia in spontaneously breathing outpatients. In the Control group (n = 25), sevoflurane and fentanyl were titrated according to standard clinical practice. In the BISdirected group (n = 25), sevoflurane was titrated to maintain a BIS value between 50 and 60, and supplemental fentanyl, 25 µg iv boluses were administered to treat tachypnea. The intraoperative anesthetic and analgesic requirements, as well as the times to eye opening, removal of the laryngeal mask airway device, response to simple commands, orientation to person and place, and postanesthesia care unit discharge eligibility (fast-track score of 14) were assessed at specific time intervals. Results:The minimum alveolar concentration-hour of sevoflurane (0.25 ± 0.15 and 0.31 ± 0.2) and end-tidal concentrations of sevoflurane at the end of surgery (0.3 ± 0.3 and 0.4 ± 0.20%) did not differ significantly between the Control and BIS-directed groups, respectively. Although the percentage of patients requiring supplemental boluses of fentanyl was reduced in the BISdirected group (16 vs 48%, P <0.05), the intraoperative BIS values and recovery times were similar in the two groups. Conclusion:In this non-paralyzed elderly outpatient surgery population, the use of BIS monitoring for titrating the maintenance anesthetic (sevoflurane) failed to improve the early recovery process. (0,25 ± 0,15 et 0,31 ± 0,2) et les concentrations télé-expiratoires de fin d'opération (0,3 ± 0,3 et 0,4 ± 0,20 %) Objectif

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“…It has been shown that neuraxial blockade produces inhibition of tonic afferent spinal signalling to the brain that produces general anaesthetic effects. Hodgson and Liu [11] observed that epidural lidocaine reduced by 34% the sevoflurane required to produce adequate depth of anaesthesia but intravenous lidocaine that had similar plasma lidocaine concentration to epidural did not. Doufas et al [12] found that sedation during epidural anaesthesia depended on sensory block level and was associated with detectable block-dependent alterations in the brainstem auditory evoked responses.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic effects of thoracic epidural anaesthesia during induction of anaesthesia: an investigation into the effects of tracheal intubation during target‐controlled infusion of propofol*

et al. 2005

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SummaryWe compared haemodynamic changes following induction of anaesthesia with propofol during tracheal intubation with and without epidural anaesthesia. Nineteen patients were divided into two groups to receive epidurally administered saline (Group C) or lidocaine 1.5% (Group E). The propofol infusion was started to produce blood concentrations of 3 lg.ml )1 , and following fentanyl and vecuronium administration, tracheal intubation was performed. Mean arterial blood pressure (MBP), heart rate (HR), Bispectral index and effect-site propofol concentration were recorded. Time to loss of consciousness was significantly shorter in Group E than in Group C. The effect-site propofol concentration at loss of consciousness was significantly lower in Group E than in Group C. MBP and HR were significantly lower following propofol induction in both groups, and were significantly increased following intubation in Group C but not in Group E. In conclusion, epidural anaesthesia did not produce profound hypotension following induction of anaesthesia and produced a reduction in the haemodynamic response to tracheal intubation during a target controlled infusion of propofol.

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Epidural Lidocaine Decreases Sevoflurane Requirement for Adequate Depth of Anesthesia as Measured by the Bispectral Index ® Monitor

Cited by 159 publications

References 0 publications

Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy

Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy

Bispectral index monitoring does not improve early recovery of geriatric outpatients undergoing brief surgical procedures

Haemodynamic effects of thoracic epidural anaesthesia during induction of anaesthesia: an investigation into the effects of tracheal intubation during target‐controlled infusion of propofol*

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