The Influence of Gender on Loss of Consciousness with Sevoflurane or Propofol

Kodaka, Mitsuharu; Johansen, Jay W.; Sebel, Peter S.

doi:10.1213/01.ane.0000154534.71371.4f

Cited by 43 publications

(37 citation statements)

References 16 publications

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“…Kodaka et al . [10] found that men required significantly more propofol than women at induction (2.9±0.2 v/s 2.7±0.1 mg/kg respectively) but there was no difference in the BIS value at loss of consciousness for men and women. Our study also showed that the decrease in dose of propofol in females compared to males and utilization of propofol for induction in both sexes were less compared to the study of Kodala et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study

2013

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Background:Clinically optimized focusing of drug administration to specific need of patient with bispectral index (BIS) monitoring results in reduced dose and faster recovery of consciousness. This study was planned with an aim to study and compare the conventional clinical end point or BIS on the requirement of dosage of propofol, hemodynamic effects, and BIS alterations following propofol induction.Methods:70 patients, ASA I and II, 20-60 years undergoing elective surgical procedure under general anesthesia with endotracheal intubation were selected and divided into two groups. Group A received (inj.) fentanyl (2 μg/kg), followed 3 min later by inj. propofol at the rate of 30 mg/kg/hr infusion till the loss of response to verbal command while group B received inj. fentanyl (2 μg/kg), followed 3 min later by inj. propofol at the rate of 30 mg/kg/hr infusion. The end point of hypnosis was when the BIS value was sustained for 1 min at 48±2. The patients were intubated. Total induction dose of propofol was noted in each group. The value of BIS and hemodynamic parameters (heart rate, systolic/diastolic blood pressure) were noted at the time of loss of consciousness, at the time of intubation, and 1 min after intubation, thereafter every minute for first 10 min and thereafter every 10 min till end of surgery. Any involuntary muscle activity such as jerky movements, dystonic posturing, and opisthotonos were also recorded.Results:The mean dose of propofol used in groups A and B were 1.85±0.48 mg/kg and 1.79±0.41 mg/kg, respectively. The dosage used in group B were less but not clinically significant (P=0.575). On comparing the dosage of propofol in males among the groups there was a significantly lower dosage of propofol required in group B (2.06±0.45 mg/kg and 1.83±0.32 mg/kg, respectively, P=0.016). This decrease however was not seen in female patients dosage being 1.65±0.44 mg/kg and 1.75±0.49 mg/kg, respectively (P=0.372). The hemodynamic variables including heart rate, systolic/diastolic blood pressure and BIS were comparable within the group at induction, post-induction, and intubation. However, there was a significant increase in all the parameters at postintubation readings (P<0.001).Conclusion:No significant difference in the induction dose of propofol was observed when assessed clinically (loss of verbal response) or by BIS monitoring. Traditional teaching to titrate the dose of propofol and depth of anesthesia during intubation by loss of verbal response is as good as BIS value monitoring.

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Section: Discussionmentioning

confidence: 99%

Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study

2013

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“…The primary endpoints used in humans to determine the threshold for LOC during induction of anaesthesia include the patient's inability to respond to non-noxious stimuli such as (i) cessation of counting (Campagna et al 2003); (ii) loss of response to verbal command (Dunnet et al 1994); (iii) suppression of the eyelash reflex (Forrest et al 1994, Gugino et al 2004; (iv) calling out one's name (Glass et al 1997); (v) uninhibited release in a handheld object (Kearse et al 1998);or (vi) light tapping on the shoulder or light shaking (Kodaka et al 2005). In addition, up to 1.3 times the minimum alveolar concentration (MAC) of halogenated volatile anaesthetics supplemented with opioids and nitrous oxide have been recommended for suppression of awareness during anaesthesia in humans (Sandin et al 2000).…”

Section: Definitions Of General Anaesthesiamentioning

confidence: 99%

EEG power spectrum analysis for monitoring depth of anaesthesia during experimental surgery

Otto

2008

Lab Anim

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SummaryThe first attempts to introduce computerized power spectrum analysis of the electroencephalogram (EEG) as an intraoperative anaesthesia monitoring device started approximately 30 years ago. Since that time, the effects of various anaesthetic agents, sedative and analgesic drugs on the EEG pattern have been addressed in numerous studies in human patients and different animal species. These studies revealed dose-dependent changes in the EEG power spectrum for many intravenous and volatile anaesthetics. Moreover, EEG responses evoked by surgical stimuli during relative light levels of surgical anaesthesia have been classified as 'arousal' and 'paradoxical arousal' reaction, previously referred to as 'desynchronization' and 'synchronization', respectively. Contrasting reports on the correlation between quantitative EEG (QEEG) variables derived from power spectrum analysis (i.e. spectral edge frequency, median frequency) and simultaneously recorded clinical signs such as movement and haemodynamic responses, however, limited the routine use of intraoperative EEG monitoring. In addition, the appearance of EEG burst suppression pattern and isoelectricity at clinically relevant concentrations/doses of newer general anaesthetics (i.e. isoflurane, sevoflurane, propofol) may have weakened the dose-related EEG changes previously reported. Despite these findings, the EEG power spectrum analysis may still provide valuable information during intraoperative monitoring in the individual subject. The information obtained from EEG power spectrum analysis may be further supplemented by newer EEG indices such as bispectral index and approximate entropy or other neurophysiological monitors including auditory evoked potentials or somatosensory evoked potentials.

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“…[13] Similar studies conducted with sevoflurane do not suggest any influence of gender on hypnotic requirements. [14] We conclude that use of epidural infusion of local anaesthetic and opioid permits a reduction in the amount of inhalational anaesthetic administered for optimum intraoperative anaesthesia. Immediate recovery and emergence is faster with desflurane when administrated using low flow anaesthesia and titrated to 0.8MAC in patients undergoing long duration cancer surgeries.…”

Section: Discussionmentioning

confidence: 81%

“…Newer volatile anaesthetic agents like desflurane and sevoflurane have significantly lower blood/gas partition coefficient (0.45 and 0.65 respectively) which facilitates rapid emergence from anaesthesia. [1,2] The clinical advantages due to favourable pharmaco kinetic properties of desflurane has been proved beyond doubt after short duration desflurane anesthesia in day care surgeries as well as major surgeries lasting 90-120 minutes, [14][15][16][17][18] but increased duration of anesthesia may amplify pharmacokinetic profile difference between halogenated agents of different solubilities. Epidural bupivacaine and lignocaine reduce the amount of inhalational agent required for maintanence of anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Emergence and Recovery Characteristics After Low Flow Anaesthesia With Desflurane and Sevoflurane in Cancer Patients Administered Combined Epidural and General Anaesthesia

Srivastava¹,

Chowdhury²,

Bhargava³

2017

Ann. Int. Med. Den.Res.

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The Influence of Gender on Loss of Consciousness with Sevoflurane or Propofol

Cited by 43 publications

References 16 publications

Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study

Clinical vs. bispectral index-guided propofol induction of anesthesia: A comparative study

EEG power spectrum analysis for monitoring depth of anaesthesia during experimental surgery

Emergence and Recovery Characteristics After Low Flow Anaesthesia With Desflurane and Sevoflurane in Cancer Patients Administered Combined Epidural and General Anaesthesia

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