Comparison of Midazolam and Propofol for BIS Guided Sedation during Regional Anaesthesia
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 1
Abstract
Bispectral Index (BIS) was introduced by Aspect Medical Systems, Inc in 1994 as a novel measure of level of consciousness by algorithmic analysis of patient’s encephalogram during anaesthesia. Besides providing an idea about the hypnotic state of the patient, it also enables titration of anaesthetic agents so as to avoid adverse effects as awareness and side effects of over doses. The ideal sedative medication should provide an early titrable level of sedation, predictable amnesia, decreased anxiety and a rapid recovery with minimal side effects. In the present study, 60 patients of either sex belonging to ASA grade I and II between age range of 2060 years posted for elective operative procedures performed under spinal anaesthesia were selected. All these patients were preanaesthetically evaluated and written valid consent was obtained. All monitors were attached and baseline parameters as pulse rate, mean arterial pressure, respiratory rate and SpO2 were noted. These 60 patients were divided into 2 equal groups of 30 patients each. In Group M, Midazolam 1% intravenous infusion in 5% Dextrose was started in dose of 0.5mg/kg/hr till BIS value more than 75 was maintained with infusion via syringe pump at 6585 range and In group P, Propofol 1% infusion in 5% Dextrose was started in dose of 6mg/kg/hr. Intraoperatively, mean pulse rate, mean arterial pressure, respiratory rate, SpO2 were monitored and noted at various time intervals. These patients were monitored intra and postoperatively for any side effects These patients were evaluated for time taken to reach required level of sedation, time taken for recovery, dose required for level of sedation, haemodynamic stability and Alderate score. It was observed that, there was no significant difference in groups M and P at various time intervals but there was statistically significant difference in mean pulse rate, mean arterial pressure amongst the groups at various time intervals, When compared to baseline readings. This difference was more significant in Propofol group as compared to Midazolam group. BIS value in both groups at various time intervals, there was significant difference. Mean time taken to reach required level of sedation was significantly greater in group M as compared to group P. Mean time taken for recovery in group M was significantly greater as compared to group P. The incidence of dreadful complications was comparatively less in both groups. Mean Alderate score on arrival in recovery room in both groups was significant and insignificant at 1 hour.
Authors and Affiliations
Shailendra D. Chauhan
Keywords
Related Articles
- EP ID EP462269
- DOI 10.21088/ijaa.2349.8471.4117.8
- Views 133
- Downloads 0
Use of Low Dose Suxamethonium to Facilitate Laryngeal Mask Insertion Under Etomidate Anesthesia
Context: Endotracheal intubation is a routine since the discovery of general anesthesia. Passage of endotracheal tube is not without morbidity, dental damage and sore throat being the commonest and serious complications....
Randomised Clinical Trial on Effect of Adding Magnesium Sulphate with 0.75% Ropivacaine and Dexmedetomidine with 0.75% Ropivacaine in Patients Undergoing Elective Laparotomy in a tertiary care hospital
Background: Laparotomies requires a good amount of pain relief postoperatively to avoid delay in recovery and reduce the duration of stay in the hospital. Among multiple modalities of pain relief postoperative wound infi...
Anesthetic Management in a Child of 11 Hydroxylase Deficiency at Rural Tertiery Care Centre, Loni
Congenital adrenal hyperplasia (CAH) is the result of an autosomal recessive disorder.It affects one of the step required for the synthesis of cortisol from cholesterol by the adrenal cortex. 11-hydroxylase deficiency a...
Comparison of Efficacy of Intraperitoneal Instillation of Ropivacaine with Ropivacaine Dexmedetomidine Combination for Post-Operative Analgesia Following Laparoscopic Cholecystectomy
Background and Aims: Intraperitoneal instillation of local anaesthetics is one of the recent techniques to minimize post-operative pain after laparoscopic surgeries. We compared the effects of intraperitoneal instillatio...
Comparison of Ultrasound and Anatomic Landmark Guided Techniques for Internal Jugular Vein Cannulation
Background and Objectives: Central venous cannulation is standard of practice in cardiothoracic surgeries for hemodynamic monitoring, administration of fluids and drugs, pacing and so on. The internal jugular vein (IJV)...