Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol

被引:4
作者
Guo, Z. G. [1 ]
Jia, X. P. [1 ]
Wang, X. Y. [1 ]
Li, P. [1 ]
Su, X. J. [1 ]
Hao, J. H. [1 ]
机构
[1] PLA, Gen Hosp, Affiliated Hosp 1, Dept Anesthesiol, Beijing, Peoples R China
关键词
Propofol; Remifentanil; Target-control infusion; Burn; MAJOR BURNS; PHARMACOKINETICS; DEXMEDETOMIDINE; INDICATORS; SURGERY;
D O I
10.4238/2015.July.13.3
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (<1 week) to BIS (A) and control (B) groups. All patients received remifentanil and propofol as intravenous TCI anesthesia. Clinical data were recorded at different time points. The time from drug withdrawal to eye opening upon the patient hearing his/her name called and upon reaching an Aldrete score of 9 points was also recorded. During anesthesia maintenance, the target concentrations of remifentanil and propofol in group A were significantly lower than that in group B (2.12 +/- 0.35 vs 2.50 +/- 0.21 ng/mL and 2.54 +/- 0.22 vs 2.86 +/- 0.31 mu g/mL, respectively; P < 0.01). The time from drug withdrawal to eye opening upon the patient hearing his/her name called and reaching an Aldrete score of 9 points in group A was considerably shorter than that in group B (7.90 +/- 0.58 vs 8.35 +/- 0.66 min and 9.15 +/- 0.69 vs 11.13 +/- 0.96 min, respectively; P < 0.01). In both groups, mean arterial pressure and heart rate values at each time point after loss of consciousness were significantly lower than the baseline values (P < 0.05), with the exception of 2 min after intubation. The use of BIS to monitor anesthetic depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.
引用
收藏
页码:7597 / 7604
页数:8
相关论文
共 21 条
[1]   The effect-site concentration of remifentanil blunting cardiovascular responses to tracheal intubation and skin incision during bispectral index-guided propefol anesthesia [J].
Albertin, A ;
Casati, A ;
Federica, L ;
Roberto, V ;
Travaglini, V ;
Bergonzi, P ;
Torri, G .
ANESTHESIA AND ANALGESIA, 2005, 101 (01) :125-130
[2]   Estimation of the Bispectral Index by Anesthesiologists An Inverse Turing Test [J].
Bottros, Michael M. ;
Palanca, Ben Julian A. ;
Mashour, George A. ;
Patel, Ami ;
Butler, Catherine ;
Taylor, Amanda ;
Lin, Nan ;
Avidan, Michael S. .
ANESTHESIOLOGY, 2011, 114 (05) :1093-1101
[3]   Exploring the pharmacokinetics of oral ketamine in children undergoing burns procedures [J].
Brunette, Katharine E. J. ;
Anderson, Brian J. ;
Thomas, Jennifer ;
Wiesner, Lubbe ;
Herd, David W. ;
Schulein, Simone .
PEDIATRIC ANESTHESIA, 2011, 21 (06) :653-662
[4]   Automated titration of propofol and remifentanil decreases the anesthesiologist's workload during vascular or thoracic surgery: a randomized prospective study [J].
Dussaussoy, Corinne ;
Peres, Marine ;
Jaoul, Virginie ;
Liu, Ngai ;
Chazot, Thierry ;
Picquet, Jean ;
Fischler, Marc ;
Beydon, Laurent .
JOURNAL OF CLINICAL MONITORING AND COMPUTING, 2014, 28 (01) :35-40
[5]   Comparison of dexmedetomidine and midazolam for conscious sedation in dental surgery monitored by bispectral index [J].
Fan, Tai Weng Victor ;
Ti, Lian Kah ;
Islam, Intekhab .
BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY, 2013, 51 (05) :428-433
[6]  
Guo Zheng-gang, 2012, Zhonghua Shao Shang Za Zhi, V28, P178
[7]   Quality and Safety Indicators in Anesthesia A Systematic Review [J].
Haller, Guy ;
Stoelwinder, Johannes ;
Myles, Paul S. ;
McNeil, John .
ANESTHESIOLOGY, 2009, 110 (05) :1158-1175
[8]   Propofol Clearance and Volume of Distribution Are Increased in Patients With Major Burns [J].
Han, Tae-Hyung ;
Greenblatt, David J. ;
Martyn, J. A. Jeevendra .
JOURNAL OF CLINICAL PHARMACOLOGY, 2009, 49 (07) :768-772
[9]   The relationship between bispectral index and targeted propofol concentration is biphasic in patients with major burns [J].
Han, TH ;
Lee, JH ;
Kwak, IS ;
Kil, HY ;
Han, KW ;
Kim, KM .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2005, 49 (01) :85-91
[10]   Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: Burns vs. non-burns [J].
Kaneda, Kotaro ;
Han, Tae-Hyung .
BURNS, 2009, 35 (06) :790-797