title: Tramadol does not modify the Bispectral Index during anaesthesia with sevoflurane and remifentanil.
abstract: BACKGROUND
  The aim of this study was to investigate the effects of tramadol administered with ketorolac on the Bispectral Index (BIS) during anaesthesia with sevoflurane and remifentanil.
  
  
  METHODS
  Forty-six adult patients, ASA I-III, scheduled for elective minor surgical procedures were studied. Patients were premedicated with remifentanil infusion 0.4 microg kg(-1) min(-1) and anaesthesia was induced 4-5 min later with propofol 1.5 mg kg(-1) and maintained with air-oxygen (FI(O(2)) 0.4), remifentanil 0.1-0.15 microg kg(-1) min(-1) and sevoflurane, adjusted to keep the BIS between 40 and 50. After 20 min of stable anaesthesia, the subjects were allocated randomly to receive i.v. tramadol 1.5 mg kg(-1) and i.v. ketorolac 0.3 mg kg(-1) (tramadol group) or saline (control group). BIS values, mean arterial pressure, heart rate and end-tidal carbon dioxide were recorded every 5 min for 20 min.
  
  
  RESULTS
  Mean BIS values after tramadol administration were not significantly different from those recorded in patients receiving saline throughout the period of observation. There were no patients who presented explicit recall of events under anaesthesia. No significant changes in mean arterial pressure, heart rate and end-tidal carbon dioxide were noted after tramadol injection.
  
  
  CONCLUSIONS
  Tramadol, given with ketorolac to prevent postoperative pain, during anaesthesia maintained with sevoflurane and remifentanil at BIS between 40 and 50, does not modify the BIS value.
authors.affiliation: Department of Neuroscience, Psychiatric and Anesthesiological Sciences, University of Messina, School of Medicine, Policlinico Universitario G. Martino, Messina, Italy. vfodale@unime.it
authors.forename: V
authors.initials: V
authors.lastname: Fodale
authors.forename: C
authors.initials: C
authors.lastname: Praticò
authors.forename: M
authors.initials: M
authors.lastname: Tescione
authors.forename: S
authors.initials: S
authors.lastname: Tanania
authors.forename: T
authors.initials: T
authors.lastname: Lucanto
authors.forename: L B
authors.initials: LB
authors.lastname: Santamaria
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics; D000704:Analysis of Variance; D000768:Anesthesia, General; D019162:Anesthetics, Combined; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000032:analysis; D016009:Chi-Square Distribution; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006339:Heart Rate; D006801:Humans; D020910:Ketorolac; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D013511:Minor Surgical Procedures; D016343:Monitoring, Intraoperative / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D010880:Piperidines; D011446:Prospective Studies; D000077208:Remifentanil; D000077149:Sevoflurane; D012815:Signal Processing, Computer-Assisted; D014147:Tramadol
chemical_list: D000700:Analgesics; D019162:Anesthetics, Combined; D008738:Methyl Ethers; D010880:Piperidines; D002245:Carbon Dioxide; D000077149:Sevoflurane; D014147:Tramadol; D000077208:Remifentanil; D020910:Ketorolac