Bispectral index monitoring during total intravenous anaesthesia: A comparative study between two dosage regimes of propofol
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 3
Abstract
Introduction The potential longterm complication of intraoperative awareness needs to be addressed These complications range from mild auditory perceptions to being fully awake Studies with prospective patient interviews that specifically inquire about awareness have noted an incidence of 01 to 02 percent in the general population and approximately 1 percent in highrisk populationsAims and Objectives Comparative evaluation of two dose regimens of propofol to assess the depth of anesthesia during total intravenouanesthesia using Bispectral index monitor The objectives were to find the average Bispectral index during propofol anaesthesia compare and determine in two groups the amount of additional bolus or reduction in the infusion rates of propofol in two dose regimens and to correlate the Bispectral indices with hemodynamic monitoring and to assess incidence of postoperative awareness in the two groupsMaterials and Methods This study was conducted as a prospective randomized doubleblind study in a teaching hospital After the approval from the Ethics committee of the institution 50 ASA III patients were randomly divided into two groups GI and GII The patients were induced with a standard regimen of 2 mg kg1 of propofol and 01 mg kg1 of vecuronium and intubated using appropriate sized endotracheal tube Following intubation propofol was infused according to the group the patients was allotted GI received propofol infusion maintenance dose of 10 mg kg1 hour for the first 10 minutes following intubation 8 mgkg1 hour for the next 10 minutes and thereafter 6 mg kg1 hour for the entire length of the surgery GII received propofol infusion maintenance dose of 8 mg kg 1hour for the first 10 minutes following intubation 6 mg kg 1hour for the next 10 minutes and thereafter 4 mg kg1 hour for the entire length of the surgery The Bispectral index blood pressure and heart rate were monitored during intubation and thereafter every five minutes for the entire length of the surgery And the propofol dose was adjusted to maintain the Bispectral index between 40 and 60Results Additional doses of propofol were required in the GII 864 mg kg1 hour regimen when compared to GI 1086 mg kg1 hour dose regimen The average Bispectral index was comparable in the two groupsConclusion Patients were hemodynamically stable when the Bispectral index was maintained between 40 and 60 Intraoperative awareness was not detected during this studyKeywords Propofol Bispectral index Intraoperative awareness
Authors and Affiliations
Pratheeba N, B Sanjeev Kumar, Remadevi R, Ravindra Bhat R, Senthilnathan M
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