Neuroleptanesthesia: current status

Bissonnette, Bruno; Swan, H; Ravussin, P.; Un, Victor

doi:10.1007/bf03012550

Cited by 32 publications

(17 citation statements)

References 89 publications

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“…Although high doses of propofol are required to produce EEG suppression, opiates usually combined with a hypnotic allow a propofol-sparing effect. High-dose infusion of sole fentanyl results in slowing of EEG progressing to the formation of delta waves (4 Hz, amplitude 50 mV) but does not produce EEG burst suppression [9]. A supraadditive interaction between fentanyl and propofol has been reported for clinical signs such as loss of consciousness, loss of the eyelash reflex, or regaining consciousness as well as EEG changes [10,11].…”

Section: Discussionmentioning

confidence: 98%

Abnormally low bispectral index and isoelectric electroencephalogram observed after administration of small doses of propofol during induction of anesthesia

2005

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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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Section: Discussionmentioning

confidence: 98%

Abnormally low bispectral index and isoelectric electroencephalogram observed after administration of small doses of propofol during induction of anesthesia

2005

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“…However, the mechanisms by which droperidol elicits this morphine-sparing effect are not clear currently [9]. Droperidol has previously been used as a premedicant before the induction of general anesthesia or, alternatively, in combination with various opioids to facilitate induction of anesthesia and potentiate opioid analgesic activity [10]. Chien and Pasternak [11] reported that combination with haloperidol, an analogue of droperidol, increases the level of morphine analgesia by 60% or more, with the increased analgesic activity mediated through blockade of the sigma receptors.…”

Section: Discussionmentioning

confidence: 98%