Impact of Bispectral Index Monitoring on Stress Response and Propofol Consumption in Patients Undergoing Coronary Artery Bypass Surgery

Bauer, Michael; Wilhelm, Wolfram; Kræmer, Thomas; Kreuer, Sascha; Brandt, Andreas; Adams, Hans Anton; Hoff, Gudrun; Larsen, Reinhard

doi:10.1097/00000542-200411000-00008

Cited by 63 publications

(36 citation statements)

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“…These findings correlated with the results of some previous clinical studies (22)(23)(24). Thus, the cardioprotective effect of remifentanil appears to be relative to direct effects on the nervous system and/or heart.…”

Section: Discussionsupporting

confidence: 92%

Cardioprotective Effects of Remifentanil in a Sympathetic Hyperactivity Model in Rabbits

Bayındır¹,

Gökmen²,

Erbayraktar³

et al. 2015

Turk J Anaesth Reanim

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Objective: In this study, the antiarrhythmic and anti-ischemic effects of a 6 µg kg −1 min −1 infusion dose of remifentanil are investigated in a central sympathetic hyperactivity model in rabbits. Methods:In this study, 18 New Zealand rabbits were used. The subjects were randomly divided into three groups (n=6) and received 10 µmol L −1 glutamate intracerebroventricularly to provide the central sympathetic hyperactivity. In group 1, 10 µmol L −1 glutamate was used; in group 2, 1 h before L-glutamate injection, 40 mg kg −1 N (omega)-nitro-L-arginine methyl ester was intravenously (iv) administered; and in group 3, also 1 h before L-glutamate injection, 40 mg kg −1 N (omega)-nitro-L-arginine methyl ester was iv administered. A 6 µg kg −1 min −1 dose of remifentanil infusion was administered 5 min before L-glutamate injection. Heart rate, systolic arterial pressure and mean arterial pressure were measured and recorded. Within 15 min of the intracerebroventricular L-glutamate injection, premature ventricular complexes, bigeminy ventricular arrhythmia, ventricular tachycardia, ST-segment shift and T-wave inversions were recorded.Results: When incidences of heart rate, rate pressure product, premature ventricular complexes and bigeminy ventricular arrhythmia were compared between groups, significant differences were not determined. Mean arterial pressure was more significantly increased in group 2 than in the other groups (p<0.05). Ventricular tachycardia, ST-segment shift and T-wave inversions were significantly lower in group 3 than in groups 1 and 2 (p<0.05). Conclusion:Remifentanil (6 µg kg −1 min −1 for 5 min of infusion) prevented life-threatening ventricular tachycardia and electrocardiographic signs of myocardial ischemia in a model of arrhythmia resulting from the association of central sympathetic overactivity.

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Section: Discussionsupporting

confidence: 92%

Cardioprotective Effects of Remifentanil in a Sympathetic Hyperactivity Model in Rabbits

Bayındır¹,

Gökmen²,

Erbayraktar³

et al. 2015

Turk J Anaesth Reanim

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“…Serum concentrations of propofol were analyzed essentially according to Bauer et al (2004) using the same analytical equipment as for midazolam. Patient samples, Cals, and QCs (300 ml serum or plasma) were all spiked with propofol-d18 as IS (CDN Isotopes Inc., Quebec, QC, Canada).…”

Section: Methodsmentioning

confidence: 99%

Effects of Hypothermia on the Disposition of Morphine, Midazolam, Fentanyl, and Propofol in Intensive Care Unit Patients

et al. 2012

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Therapeutic hypothermia (TH) may induce pharmacokinetic changes that may affect the level of sedation. We have compared the disposition of morphine, midazolam, fentanyl, and propofol in TH with normothermia in man. Fourteen patients treated with TH following cardiac arrest (33-34°C) were compared with eight matched critically ill patients (36-38°C). Continuous infusions of morphine and midazolam were stopped and replaced with infusions of fentanyl and propofol to describe elimination and start of infusion pharmacokinetics, respectively. Serial serum and urine samples were collected for 6-8 hours for validated quantification and subsequent pharmacokinetic analysis. During TH, morphine elimination half-life (t 1/2 ) was significantly higher, while total clearance (CL tot ) was significantly lower (median [semiinterquartile range (s-iqr)]): t 1/2 , 266 (43) versus 168 (11) minutes, P < 0.01; CL tot , 1201 (283) versus 1687 (200) ml/min, P < 0.01. No significant differences were seen for midazolam. CL tot of fentanyl and propofol was significantly lower in hypothermic patients [median (s-iqr)]: fentanyl, 726 (230) versus 1331 (678) ml/min, P < 0.05; propofol, 2046 (305) versus 2665 (223) ml/min, P < 0.05. Compared with the matched, normothermic intensive care unit patients, t 1/2 of morphine was significantly higher during TH. CL tot was lower during TH for morphine, fentanyl, and propofol but not for midazolam. Reducing the infusion rates of morphine, fentanyl, and propofol during TH is encouraged

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“…[18] yaptığı çalışmaya benzer olarak BIS grubunda propofol ve remifentanil'in hem indüksiyon hemde idame dozlarının kontrol grubuna göre istatistiksel olarak anlamlı derecede düşük olduğu ve beraberinde farkındalık olmadığı gösterildi.…”

Section: Discussionunclassified

Bispektral İndeks (BIS) ile total intravenöz anestezi derinliği izlemi; propofol ajan tüketimi, derlenme kriterleri ve farkında olmaya etkisi

Özensoy¹,

Ayazoğlu²,

Çalım³

et al. 2013

CMJ

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ÖzetAmaç. Bispektral İndeks (BIS) ile anestezi derinliği izlemenin, kullanılan total intravenöz anestezik madde tüketimi ve derlenme kriterleri ve farkında olmaya etkisini araştırmak araştırmak üzere planlandı. Yöntem. Genel anestezi ile kolesistektomi planlanan, 20-60 yaş arası, ASA I-III, 60 hasta çalışmaya alındı. Olgular rasgele 2 gruba ayrıldı. Bispektral indeks monitörizasyonu ile izlenen grup; Grup BIS, hemodinamik parametrelerle izlenen grup; Grup Kontrol olarak sınıflandırıldı. Her iki grupta da anestezi indüksiyonunda 1 μg kg -1 remifentanil uygulandı. Kontrol grubunda propofol 2 mg kg -1 , BIS grubunda BIS 40-60 arasında olacak şekilde ayarlandı. 0,6 mg kg -1 rocuronyum ile hastalar kürarize edildi. Anestezi idamesi propofol ve remifentanil ile yapıldı. Toplam propofol tüketimi, ekstübasyon zamanı ve farkında olma kaydedildi. Bulgular. Demografik veriler gruplar arasında benzerdi. BIS grubunda propofol tüketimi (p<0,05), anlamlı olarak düşük bulundu. Ekstübasyon zamanı BIS grubunda daha kısa bulundu (p<0,05), farkında olma açısından gruplar arasında fark bulunmadı. Her iki grup, kalp atım hızları, ortalama arteriyel basınçları ve hastanede kalış süreleri bakımından benzerdi. Sonuç. ASA I-III laparoskopik kolesistektomi uygulanan hastalarda anestezi titrasyonunu hemodinamik parametrelere göre yapmanın yeterli olduğu ancak BIS ile monitörize takip etmenin fazla anestezik ajan kullanımını önlemeye ve anesteziden daha hızlı derlenmeye yardımcı olduğu kanısına varıldı. Anahtar sözcükler: Total intravenöz anestezi, EEG, bispektral indeks Abstract Aim. We aimed to investigate the effect of monitoring the depth of anesthesia with bispectral Index (BIS) on consumption of total intravenous anesthetic agent, recovery criteria and to be aware. Methods. ASA physical status I-II, between 20-60 age, 60 patients planned to undergoing cholecystectomy under general anesthesia were enrolled to study. Patients were randomly divided into 2 groups. Patients monitored by bispectral index monitoring (BIS) were classified as Group BIS and patients monitored by hemodynamic parameters were classified as group control. Induction of anesthesia in both groups was performed with 1 mg/kg/min remifentanil. In Group Control, propofol was adjusted to 2 mg/kg, in group BIS, propofol was adjusted to BIS 40-60. All patients were curarized with rocuronyum 0.6 mg kg -1 . Maintenance of anesthesia was caried out with propofol and remifentanil. Total propofol consumption and time to extubation and to be aware were also recorded. Results. Demographic data were similar between groups. In BIS group, propofol consumption (p<0.05) were significantly lower. Time to extubation was shorter in the BIS group (p<0.05) differences were not found between the groups in terms of being aware. Both groups were similar in terms of heart rate, mean arterial pressure, and length of hospital stay. Conclusion. In patients undergoing laparoscopic cholecystectomy, it is enough to make anesthesia titration by hemodynamic parameters. However, we concluded that monitor...

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Impact of Bispectral Index Monitoring on Stress Response and Propofol Consumption in Patients Undergoing Coronary Artery Bypass Surgery

Cited by 63 publications

References 0 publications

Cardioprotective Effects of Remifentanil in a Sympathetic Hyperactivity Model in Rabbits

Cardioprotective Effects of Remifentanil in a Sympathetic Hyperactivity Model in Rabbits

Effects of Hypothermia on the Disposition of Morphine, Midazolam, Fentanyl, and Propofol in Intensive Care Unit Patients

Bispektral İndeks (BIS) ile total intravenöz anestezi derinliği izlemi; propofol ajan tüketimi, derlenme kriterleri ve farkında olmaya etkisi

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