title: Changes of bispectral index during recovery from general anesthesia with 2% propofol and remifentanil in children.
abstract: 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.
authors.affiliation: Department of Anesthesiology, College of Medicine, Eulji University, Korea.
authors.forename: Hye-Jin
authors.initials: HJ
authors.lastname: Park
authors.forename: Yong Lak
authors.initials: YL
authors.lastname: Kim
authors.forename: Chong Sung
authors.initials: CS
authors.lastname: Kim
authors.forename: Seong Deok
authors.initials: SD
authors.lastname: Kim
authors.forename: Hee-Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: 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
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol