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Narcotrend, bispectral index, and classical electroencephalogram variables during emergence from propofol/remifentanil anesthesia.

Abstract：

UNLABELLED:The aim of this study was to investigate modern and classical electroencephalographic (EEG) variables in response to remifentanil and propofol infusions. We hypothesized that modern EEG variables may indicate the effects of propofol but not of remifentanil. Twenty-five patients were included in the study after the end of elective spine surgery without any surgical stimulation. Baseline values were defined with remifentanil 0.3 microg. kg(-1). min(-1) and target-controlled infusion of propofol 3.0 microg/mL. EEG changes were evaluated 1, 3, 5, 7, and 9 min after the stop of remifentanil infusion, followed by a step-by-step reduction (0.2 microg/mL) every 3 min of target-controlled infusion propofol. Narcotrend (NT; classifying EEG stages from awake to deep anesthesia), bispectral index (BIS), EEG spectral frequency bands (%), 50% (Median) and 95% percentiles (spectral edge frequency), mean arterial blood pressure, heart rate, and oxygen saturation were detected at every time point. The end of remifentanil application resulted in significant increases in %alpha, spectral edge frequency, mean arterial blood pressure, and %theta and decreases in %delta (P < 0.05). NT, BIS, Median, heart rate, and oxygen saturation were unchanged. Decreases in propofol concentration were associated with statistically significant increases in NT and BIS (P < 0.05). Thus, the sedative-hypnotic component of propofol could be estimated by modern EEG variables (NT and BIS), whereas the analgesic component provided by remifentanil was not indicated. However, during conditions without surgical stimulation, neither NT nor BIS provided an adequate assessment of the depth of anesthesia when a remifentanil infusion was used. IMPLICATIONS:We investigated modern and classical electroencephalographic (EEG) variables during emergence from propofol/remifentanil anesthesia. Modern EEG variables indicate changes of infusion in propofol, but not in remifentanil. Thus, modern EEG variables did not provide an adequate assessment of depth of anesthesia when remifentanil was used.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Schmidt GN,Bischoff P,Standl T,Voigt M,Papavero L,Schulte am Esch J

doi

10.1097/00000539-200211000-00042

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

1324-30, table of contents

issue

eissn

0003-2999

issn

1526-7598

journal_volume

pub_type

临床试验,杂志文章

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Narcotrend, bispectral index, and classical electroencephalogram variables during emergence from propofol/remifentanil anesthesia.