The BIS and hemodynamic changes in major burn patients according to a slow infusion of propofol for induction

Abstract

BackgroundMany pathophysiologic alterations in patients with major burns can cause changes in the response of propofol. The aim of this study is to determine the appropriate induction dose of propofol using a slow infusion rate for major burn patients to obtain desirable sedation and hypnotic conditions with minimal hemodynamic changes.Methods45 adults with major burns and who were electively scheduled for escharectomy less than a week after injury were recruited. For induction with propofol, the patients were randomly allocated to one of two groups (group 1: 1.5 mg/kg, n = 20 and group 2: 2.0 mg/kg, n = 25). The infusion rate was 20 mg/kg/hr. The systolic and diastolic blood pressure (SBP, DBP), the heart rate, the bispectral index and the modified observers' assessment of the alertness/sedation scale (OAA/S) were measured before the induction and after the propofol infusion, as well as immediately, 3 and 5 minutes after intubation.ResultsThe SBP and DBP were significantly decreased after the propofol infusion in both group, but there were no significant differences between the two groups. The BIS values after the propofol infusion and intubation were 44.2 ± 16.1 and 43.5 ± 13.8 in group 1, and 45.6 ± 10.3 and 46.5 ± 11.4 in group 2, respectively, and there were no differences between the 2 groups.ConclusionsWhen propofol is administrated to major burn patients, an induction dose of 1.5 mg/kg is appropriate and a slow infusion rate of 20 mg/kg/hr is safe for maintaining the desired hypnotic conditions and this dose and rate cause no significant hemodynamic problems.

The Effect of BIS Usage on Anaesthetic Agent Consumption, Haemodynamics and Recovery Time in Supratentorial Mass Surgery

“…Among studies on BIS, very few of them compare intraoperative haemodynamic variables. Some of them are experimental, some of them are performed on a small number of patients and some only evaluate the intubation period (13)(14)(15). We observed that the heart rates of the control patients in the 1 st and 2 nd period were statistically significantly higher than that of the BIS patients.…”

Association between bispectral index and age and use of sedative drugs in high spinal anaesthesia

“…Others have shown temporal correlations between BIS and conventional sedation measures, 24,25 suggesting that BIS monitoring is useful for evaluating sedation. 4,24 Both the depth of sedation and BIS values have been shown to correlate with the level of spinal block. 6,15 Secondly, BIS is sensitive to internal or external patient circumstances and can be affected by abrupt arousal, movement, coughing or noise in patients with light or no additional sedation.…”

Utility of bispectral index in the management of multiple trauma patients

“…Moreover, BIS-guided anesthesia lead to reductions in use of hypnotics. [ 1 4 11 ] Recently, its use has been extended to ICU patients. [ 14 15 24 26 ] The present study analyzes the utility of BIS monitors in mechanically ventilated patients in trauma ICU.…”