[Which doses of anaesthetic agents in centenarian patients? Interest of BIS monitoring].
A 106-year-old female underwent emergency colectomy for peritonitis secondary to ischemic colitis. Following induction of anaesthesia with 18 mg etomidate (0,4 mg/kg), BIS monitoring allowed to perform surgery with an averaged desflurane end-tidal concentration and remifentanil infusion as low as 0.9% and 0.057 microg/kg/minute respectively. The mean BIS value was of 45+/-4 (min = 38, max = 50), systolic arterial pressure was maintained within+/-10% of control values during 72% of anaesthesia duration (160 min) and the maximal drop did not exceed 27%. No adrenergic agent was used. This observation underlined the interest of BIS when anaesthetic requirement are difficult to estimate rapidly.
Passot
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Département d'anesthésie-réanimation, hôpital Bellevue, boulevard Pasteur, 42055 Saint-Etienne cedex 02, France.
Molliex
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S
D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology*; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D003082:Colectomy; D017091:Colitis, Ischemic / Q000150:complications / Q000601:surgery; D000077335:Desflurane; D004562:Electrocardiography / Q000187:drug effects; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives; D016343:Monitoring, Intraoperative; D010538:Peritonitis / Q000209:etiology
D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane