- Volume 14 Issue 5
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The relationship between lowest bispectral index value and age in high spinal anesthesia
고위 척추마취에서 마취심도감시장치를 이용한 나이에 따른 진정 정도의 비교
- Hwang, Byeong-Mun (Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, Kangwon National University Medical School)
- 황병문 (강원대학교 의학전문대학원 마취통증과)
- Received : 2013.02.12
- Accepted : 2013.05.09
- Published : 2013.05.31
The aim of this study was to quantify the sedative effects of high spinal anesthesia, according to patient age, by also evaluating respiratory and hemodynamic changes. A prospective study was performed in 60 patients who were electively scheduled for lower limb or lower abdominal surgery. They were allocated into one of 2 groups according to their age: older age (51-80 years) and young age (20-50 years). In all groups, the lowest intraoperative bispectral index (BIS) values significantly lower than preoperative values. Patients in the older age group had significantly lower intraoperative BIS values than younger patients. The sedative effect of high spinal anesthesia is greater in older patients than in young patients, with an increase in respiratory instability. Our study showed a negative correlation between age and lowest BIS value; the lowest BIS value was reduced in older patients.
Age;Bispectral index;Sedation;Spinal anesthesia
- Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC. Clinical anesthesia. p.927-954, Lippincott Williams & Willikins, 2009.
- Chen SC, Rex DK. "An initial investigation of bispectral monitoring as an adjunct to nurse-administered propofol sedation for colonoscopy" Am J Gastroenterol, Vol. 99, No. 6, pp. 1081-1086, 2004. DOI: http://dx.doi.org/10.1111/j.1572-0241.2004.03279.x https://doi.org/10.1111/j.1572-0241.2004.03279.x
- Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. "Sedation during spinal anesthesia" Anesthesiology, Vol. 93, No. 3, pp. 728-734, 2000. DOI: http://dx.doi.org/10.1097/00000542-200009000-00022 https://doi.org/10.1097/00000542-200009000-00022
- Nishikawa K, Hagiwara R, Nakamura K, Ishizeki J, Kubo K, Saito S, Goto F. "The effects of the extent of spinal block on the BIS score and regional cerebral oxygen saturation in elderly patients: a prospective, randomized, and double-blinded study" J Clin Monit Comput, Vol. 21, No. 2, pp. 109-114, 2007. DOI: http://dx.doi.org/10.1007/s10877-006-9063-7 https://doi.org/10.1007/s10877-006-9063-7
- Kurup V, Ramani R, Atanassoff PG. "Sedation after spinal anesthesia in elderly patients: a preliminary observational study with the PSA-4000" Can J Anaesth, Vol. 51, No. 6, pp. 562-565, 2004. DOI: http://dx.doi.org/10.1007/BF03018398 https://doi.org/10.1007/BF03018398
- Iida R, Iwasaki K, Kato J, Ogawa S. "Bispectral index is related to the spread of spinal sensory block in patients with combined spinal and general anaesthesia" Br J Anaesth, Vol. 106, No. 2, pp. 202-207, 2011. DOI: http://dx.doi.org/10.1093/bja/aeq359 https://doi.org/10.1093/bja/aeq359
- Antognini JF, Jinks SL, Atherley R, Clayton C, Carstens E. "Spinal anaesthesia indirectly depresses cortical activity associated with electrical stimulation of the reticular formation" Br J Anaesth, Vol. 91, No. 2, pp. 233-238, 2003. DOI: http://dx.doi.org/10.1093/bja/aeg168 https://doi.org/10.1093/bja/aeg168
- Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. "Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers" Anesthesiology, Vol. 86, No. 4, pp. 836-847, 1997. DOI: http://dx.doi.org/10.1097/00000542-199704000-00014 https://doi.org/10.1097/00000542-199704000-00014
- Kang JG, Lee JJ, Kim da M, Kim JA, Kim CS, Hahm TS, Lee BD. "Blocking noise but not music lowers bispectral index scores during sedation in noisy operating rooms" J Clin Anesth, Vol. 20, No. 1, pp. 12-16, 2008. DOI: http://dx.doi.org/10.1016/j.jclinane.2007.06.005 https://doi.org/10.1016/j.jclinane.2007.06.005
- Singh H. "Bispectral index (BIS) monitoring during propofol-induced sedation and anaesthesia" Eur J Anaesthesiol, Vol. 16, No. 1, pp. 31-36, 1999. DOI: http://dx.doi.org/10.1046/j.1365-2346.1999.00420.x https://doi.org/10.1046/j.1365-2346.1999.00420.x
- Kushida A, Murao K, Kimoto M, Nakao S, Shingu K. "Fentanyl shows different effects by administration routes on bispectral index during spinal anesthesia in patients undergoing cesarean section" Masui, Vol. 55, No. 11, pp. 1393-1397, 2006.
- Nakamoto M, Murao K, Kimoto M, Nakao S, Shingu K. "Specific gravity of bupivacaine with fentanyl influences bispectral index value during spinal anesthesia combined with fentanyl in patients undergoing cesarean section" Masui, Vol. 58, No. 4, pp. 460-462, 2009.
- Yaddanapudi S, Batra, Y, Balagopal A, Nagdeve N. "Sedation in patients above 60 years of age undergoing urological surgery under spinal anesthesia: Comparison of propofol and midazolam infusions" J Postgrand Med, Vol. 53, No. 3, pp. 171-175, 2007. DOI: http://dx.doi.org/10.4103/0022-3859.33858 https://doi.org/10.4103/0022-3859.33858
- Mahoori A, Noroozinia H, Hassani E, Motargemzadeh G, Sadeghi A. "The effect of aging on bispectral index before and after sedation: a prospective study" Tehran Univ Med J, Vol. 68, No. 5, pp. 295-299, 2010.
- Sieber FE, Gottshalk A, Zakriya KJ, Mears SC, Lee H. "General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia" J Clin Anesth, Vol. 22, No. 3, pp. 179-183, 2010. DOI: http://dx.doi.org/10.1016/j.jclinane.2009.06.005 https://doi.org/10.1016/j.jclinane.2009.06.005
- Caplan RA, Ward RJ, Posner K, Cheney FW. "Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors" Anesthesiology, Vol. 68, No. 1, pp. 5-11, 1988. DOI: http://dx.doi.org/10.1097/00000542-198801000-00003 https://doi.org/10.1097/00000542-198801000-00003
- Devabhakthuni S, Armahizer MJ, Dasta JF, Kane-Gill SL. "Analgosedation: a paradigm shift in intensive care unit sedation practice" Ann Pharmacother, Vol. 46, No. 4, pp. 530-540, 2012. DOI: http://dx.doi.org/10.1345/aph.1Q525 https://doi.org/10.1345/aph.1Q525
- Rosow C, Manberg PJ. "Bispectral index monitoring" Anesthesiol Clin North America, Vol. 19, No. 4, pp. 947-966, 2001. DOI: http://dx.doi.org/10.1016/S0889-8537(01)80018-3 https://doi.org/10.1016/S0889-8537(01)80018-3
- Qadeer MA, Vargo JJ, Patel S, Dumot JA, Lopez AR, Trolli PA, Conwell DL, Stevens T, Zuccaro G Jr. "Bispectral index monitoring of conscious sedation with the combination of meperidine and midazolam during endoscopy" Clin Gastroenterol Hepatol, Vol. 6, No. 1, pp. 102-108, 2008. DOI: http://dx.doi.org/10.1016/j.cgh.2007.10.005 https://doi.org/10.1016/j.cgh.2007.10.005
- Bae JY, Do Choi Y, Woo CH, Kwak IS, Mun SH, and Kim KM. "The BIS and hemodynamic changes in major burn patients according to a slow infusion of propofol for induction" Korean J Anesthesiol, Vol. 60, No. 3, pp. 161-166, 2011. DOI: http://dx.doi.org/10.4097/kjae.2011.60.3.161 https://doi.org/10.4097/kjae.2011.60.3.161
- Gentili M, Huu PC, Enel D, Hollande J, Bonnet F. "Sedation depends on the level of sensory block induced by spinal anaesthesia" Br J Anaesth, Vol. 81, No. 6, pp. 970-971, 1998. DOI: http://dx.doi.org/10.1093/bja/81.6.970 https://doi.org/10.1093/bja/81.6.970