Ketamine has no effect on bispectral index during stable propofol–remifentanil anaesthesia

Faraoni, David; Salengros, Jean-Corentin; Engelman, Edgard; Ickx, Brigitte; Barvais, Luc

doi:10.1093/bja/aen403

Cited by 34 publications

(25 citation statements)

References 18 publications

(6 reference statements)

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“…In contrast, Vereecke et al [27] concluded that ketamine administration alone or with rocuronium could not affect BIS readings significantly so that the clinical setting should be considered during the interpretation of all indices. In addition, Faraoni et al [28] found that BIS values did not increase with ketamine in the absence of surgical stimulation. They removed the surgical pain effect on the EEG cortical measurements, which was reported to increase the BIS readings [29].…”

Section: Discussionmentioning

confidence: 99%

Perioperative effects of various anesthetic adjuvants with TIVA guided by bispectral index

Khafagy

Ebied

Osman

et al. 2012

Korean J Anesthesiol

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BackgroundThis prospective, randomized, double blinded, controlled study was designed to compare effects of intravenous co-administration of clonidine, magnesium, or ketamine on anesthetic consumption, intraoperative hemodynamics, postoperative analgesia and recovery indices during Bispectral Index (BIS) guided total intravenous anesthesia (TIVA).MethodsAfter ethical committee approval and written informed consent, 120 adult patients ASA I and II scheduled for open cholecystectomy were randomly assigned to one of 4 equal groups. Group CL received clonidine 3 µg/kg and maintained by 2 µg/kg/h. Group MG received magnesium sulphate 50 mg/kg and maintained by 8 mg/kg/h. Group KET received racemic ketamine 0.4 mg/kg and maintained by 0.2 mg/kg/h. Control group (CT) received the same volume of isotonic saline. Anesthesia was induced and maintained by fentanyl, propofol and rocuronium. Propofol infusion was adjusted to keep the BIS value between 45-55. Intraoperative hemodynamics, induction time, anesthetic consumption, recovery indices, and PACU discharge were recorded.ResultsInduction time, propofol requirements for induction and maintenance of anesthesia, intraoperative fentanyl and hemodynamic values were significantly lower with Groups CL and MG compared to Groups KET and CT (P < 0.05). Patients in Group MG showed significantly lower muscle relaxant consumption, delayed recovery and PACU discharge than other groups (P < 0.05). First, analgesic requirement was significantly longer and total postoperative analgesic consumption was significantly lower in the adjuvant groups versus Group CT (P < 0.05).ConclusionsClonidine, magnesium, and ketamine can be useful adjuvant agents to BIS-guided TIVA. Pharmacokinetic studies of such drug combinations were recommended to investigate their interaction.

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Section: Discussionmentioning

confidence: 99%

Perioperative effects of various anesthetic adjuvants with TIVA guided by bispectral index

Khafagy

Ebied

Osman

et al. 2012

Korean J Anesthesiol

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“…Hans et al [13] concluded that a ketamine bolus of 0.5 mg/kg also significantly increases the BIS values, during a sevoflurane anaesthesia. Faraoni et al [12] showed that a ketamine bolus of 0.2 mg/kg administered over 5 min did not increase the BIS value over the next 15 min, during a propofol and remifentanil targetcontrolled infusion and Sengupta et al [11] verified, more recently, that a bolus dose of ketamine 0.2 mg/kg did not affect BIS values during propofol-fentanyl anaesthesia whereas a bolus dose of 0.5 mg/kg increased BIS values.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, several authors have assessed the effect of different analgesic doses of ketamine in BIS values [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Cerebral and Cardiovascular Effects of Analgesic Doses of Ketamine During a Target Controlled General Anesthesia-a Prospective Randomized Study

Campos¹,

Araújo²,

Nunes³

et al. 2017

J Anesth Clin Res

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“…Some studies showed that TIVA with propofol and remifentanil do not affect BIS when infusing a low dose ketamine [27], while Hans et al [28] reported that anesthesia with sevoflurane increased BIS. In our study, BIS was higher in group K than C group, but both were within the range of general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Effects of intraoperative low dose ketamine on remifentanil-induced hyperalgesia in gynecologic surgery with sevoflurane anesthesia

Hong

Lee

Kim

et al. 2011

Korean J Anesthesiol

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BackgroundRemifentanil is useful during general anesthesia because of its rapid onset and short acting time. However, some studies report that due to opioid-induced hyperalgesia (OIH) and tolerance, remifentanil also increases early postoperative pain. The occurrence of OIH and opioid-induced tolerance is mainly thought to be due to central sensitization by the activation of NMDA receptors. Therefore, we investigated the effects of continuous infusion of ketamine, an NMDA receptor antagonist, on postoperative pain and the quantity of opioids used.Methods40 patients scheduled to undergo laparoscopic gynecologic surgery were randomly allocated into two groups. Anesthesia was equally maintained with sevoflurane and 4 ng/ml of remifentanil in all patients. Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 µl/kg/min in the ketamine group (n = 20) while the control group was injected and infused with an equal amount of normal saline. We compared postoperative VAS up to 7 hours and morphine demand through PCA.ResultsPostoperative VAS and morphine demand was significantly lower in the ketamine group 2 and 3 hours after surgery, respectively.ConclusionsWhen general anesthesia is maintained with sevoflurane and remifentanil in patients undergoing laparoscopic gynecologic surgery, continuous infusion of low dose ketamine decreased early postoperative pain and the quantity of opioids used.

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Ketamine has no effect on bispectral index during stable propofol–remifentanil anaesthesia

Abstract: Under stable propofol and remifentanil TCI anaesthesia, a slow bolus infusion of ketamine 0.2 mg kg(-1) administered over a 5 min period did not increase the BIS value over the next 15 min.

Cited by 34 publications

References 18 publications

Perioperative effects of various anesthetic adjuvants with TIVA guided by bispectral index

Perioperative effects of various anesthetic adjuvants with TIVA guided by bispectral index

Cerebral and Cardiovascular Effects of Analgesic Doses of Ketamine During a Target Controlled General Anesthesia-a Prospective Randomized Study

Effects of intraoperative low dose ketamine on remifentanil-induced hyperalgesia in gynecologic surgery with sevoflurane anesthesia

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