Change of Bispectral Index and Hemodynamic Index During Induction and Orotracheal Intubation of Sevoflurane Anesthesia_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Wei ¹ ,  WANG Jian ¹ , LUO Linli ² , ZHOU Jun ¹

1. Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China 2. Department of Anesthesiology,West China Second Hospital,Sichuan University,Chengdu 610041,China;

Corresponding author：

WANG Jian, Email: hw80@163.com

Keywords：

Sevoflurane; Succinylcholin; Bispectral index; Hemodynamics; General anesthesia; Tracheal intubation

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Objective　 To investigate change of bispectral index(BIS) and hemodynamic index during induction and orotracheal intubation of sevoflurane anesthesia.
Methods　 This study was a prospective before-after study in the same patients. A total of 30 ASA physical status I and II adult patients without airway abnormalities were enrolled to receive inhalation induction of anesthesia with 8% sevoflurane. Mean arterial pressure(MAP),heart rate(HR) and BIS were recorded before anesthesia(T1),when patients loss of consciousness(T2), before intubation (T3),at 1 min(T4) and 3 min(T5) after intubation.
Results　 BIS at T1-T5 were 96.8±1.7,70.4±8.8,39.2±8.4,43.6±12.9 and 41.6±9.3 respectively, the measurements at T2-T5 were all markedly lower than at T1(P lt;0.05). HR at T3-T5 were all markedly higher than at T1(P lt;0.05). MAP at T2 and T3 were markedly lower than at T1, but at T4 was higher than at T1(P lt;0.05), and recovered to the level at T1 at T5(P gt;0.05).BIS,HR and MAP at T4 were all significantly higher than T3(P lt;0.05).
Conclusion　 Anesthesia induction with sevoflurane and small dose of succinylchoiline we used can provide adequate depth of general anesthesia,but can not prevent cardiovascular adverse reactions to intubation.

Citation： HUANG Wei,WANG Jian,LUO Linli,ZHOU Jun. Change of Bispectral Index and Hemodynamic Index During Induction and Orotracheal Intubation of Sevoflurane Anesthesia. Chinese Journal of Evidence-Based Medicine, 2007, 07(12): 869-872. doi: Copy

1.	Muzi M, Robinson BJ, Ebert TJ,et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology, 1996,85(3): 536-543.
2.	Ekman A, Lindholm ML, Lennmarken C, et al. Reduction in the incidence of awareness using BIS monitoring.Acta Anaesthesiol Scand, 2004, 48(1): 20-26.
3.	Myles PS, Leslie K, Forbes A, et al. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomized controlled trial. Lancet, 2004,363 (9423): 1757-1763.
4.	Guignard B, Menigaux C,Dupont X,et al.The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg, 2000, 90(1): 161-167.
5.	Patel SS,Goa KL. Sevoflurane:A review of its pharmacodynamics and pharmacokinetic properties and its clinical use in general anaesthesia.Drugs,1996,51(4): 658-700.
6.	Edwards ND, Alford AM,Dobson PM, et al. Myocardial ischaemia during tracheal intubation and extubation. Br J Anaesth,1994, 73(4) : 537-539.
7.	Guignard B,Chauvin M. Bispectral index increases and decreases are not always signs of inadequate anesthesia. Anesthesiology, 2000,2(3): 903-905.
8.	El-Orbany MI, Joseph NJ, Salem MR, et al. The neuromuscular effects and tracheal intubation conditions after small doses of succinylcholine. Anesth Analg, 2004,98(6): 1680-1685.
9.	Kopman AF,Zhaku B,Lai KS. The “intubating dose” of succinylcholine: the effect of decreasing doses on recovery time.Anesthesiology, 2003,99(5): 1050-1043.

1. Muzi M, Robinson BJ, Ebert TJ,et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology, 1996,85(3): 536-543.
2. Ekman A, Lindholm ML, Lennmarken C, et al. Reduction in the incidence of awareness using BIS monitoring.Acta Anaesthesiol Scand, 2004, 48(1): 20-26.
3. Myles PS, Leslie K, Forbes A, et al. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomized controlled trial. Lancet, 2004,363 (9423): 1757-1763.
4. Guignard B, Menigaux C,Dupont X,et al.The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg, 2000, 90(1): 161-167.
5. Patel SS,Goa KL. Sevoflurane:A review of its pharmacodynamics and pharmacokinetic properties and its clinical use in general anaesthesia.Drugs,1996,51(4): 658-700.
6. Edwards ND, Alford AM,Dobson PM, et al. Myocardial ischaemia during tracheal intubation and extubation. Br J Anaesth,1994, 73(4) : 537-539.
7. Guignard B,Chauvin M. Bispectral index increases and decreases are not always signs of inadequate anesthesia. Anesthesiology, 2000,2(3): 903-905.
8. El-Orbany MI, Joseph NJ, Salem MR, et al. The neuromuscular effects and tracheal intubation conditions after small doses of succinylcholine. Anesth Analg, 2004,98(6): 1680-1685.
9. Kopman AF,Zhaku B,Lai KS. The “intubating dose” of succinylcholine: the effect of decreasing doses on recovery time.Anesthesiology, 2003,99(5): 1050-1043.

Chinese Journal of Evidence-Based Medicine

Change of Bispectral Index and Hemodynamic Index During Induction and Orotracheal Intubation of Sevoflurane Anesthesia

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