Changes of bispectral index during recovery from general anesthesia with 2% propofol and remifentanil in children.
BACKGROUND
The bispectral (BIS) index is a pharmacodynamic measure of the effect of anesthesia on the central nervous system. The aim of this study was to investigate the relationship between BIS index and predicted plasma concentration of propofol delivered by target controlled infusion (TCI) during emergence in children.


METHODS
With approval of IRB, 30 patients (2-7 years) were included in this study. Anesthesia was with TCI propofol 3-5 microg.ml(-1) and remifentanil 7.5 ng.ml(-1) to maintain BIS 40-60 and the propofol concentration was fixed at 3 microg.ml(-1) Remifentanil infusion was stopped 10 min before the end of surgery. BIS values were recorded after reducing propofol in decrement of 0.2 microg.ml(-1). BIS values were checked when spontaneous respiration occurred and children were able to obey a command (eye opening or hand grasping).


RESULTS
Spearman's correlation analysis showed negative correlation between BIS and propofol plasma concentration (r = -0.559, P < 0.001). When respiration returned, mean BIS was 77.2 +/- 5.3 and propofol plasma concentration 1.6 +/- 0.3 microg.ml(-1) and when a verbal command was obeyed, BIS was 82.4 +/- 5.6 and propofol plasma concentration 1.5 +/- 0.3 microg.ml(-1).


CONCLUSIONS
In preschool children, BIS moderately correlated with the predicted plasma concentration of propofol.
Park
Hye-Jin
HJ
Department of Anesthesiology, College of Medicine, Eulji University, Korea.
Kim
Yong Lak
YL
Kim
Chong Sung
CS
Kim
Seong Deok
SD
Kim
Hee-Soo
HS
D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000097:blood / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010880:Piperidines / Q000097:blood / Q000494:pharmacology*; D011237:Predictive Value of Tests; D015742:Propofol / Q000097:blood / Q000494:pharmacology*; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol