title: The optimal anesthetic depth for interventional neuroradiology: comparisons between light anesthesia and deep anesthesia.
abstract: BACKGROUND
  This study was designed to determine the optimal anesthetic depth for the maintenance and recovery in interventional neuroradiology.
  
  
  METHODS
  Eighty-eight patients undergoing interventional neuroradiology were randomly allocated to light anesthesia (n = 44) or deep anesthesia (n = 44) groups based on the value of the bispectral index (BIS). Anesthesia was induced with propofol, alfentanil, and rocuronium and maintained with 1-3% sevoflurane. The concentration of sevoflurane was titrated to maintain BIS at 40-49 (deep anesthesia group) or 50-59 (light anesthesia group). Phenylephrine was used to maintain the mean arterial pressure within 20% of preinduction values. Recovery times were recorded.
  
  
  RESULTS
  The light anesthesia group had a more rapid recovery to spontaneous ventilation, eye opening, extubation, and orientation (4.1 ± 2.3 vs. 5.3 ± 1.8 min, 6.9 ± 3.2 min vs. 9.1 ± 3.2 min, 8.2 ± 3.1 min vs. 10.7 ± 3.3 min, 10.0 ± 3.9 min vs. 12.9 ± 5.5 min, all P < 0.01) compared to the deep anesthesia group. The use of phenylephrine was significantly increased in the deep anesthesia group (768 ± 184 vs. 320 ± 82 µg, P < 0.01). More patients moved during the procedure in the light anesthesia group (6/44 [14%] vs. 0/44 [0%], P = 0.026).
  
  
  CONCLUSIONS
  BIS values between 50 and 59 for interventional neuroradiology were associated with a more rapid recovery and favorable hemodynamic response, but also with more patient movement. We suggest that maintaining BIS values between 40 and 49 is preferable for the prevention of patient movement during anesthesia for interventional neuroradiology.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yoo Sun
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ye-Reum
authors.initials: YR
authors.lastname: Han
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun-Su
authors.initials: ES
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Byung-Gun
authors.initials: BG
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
keywords: Bispectral index monitor; General anesthesia; Interventional radiology; Sevoflurane
references.citation: Anesthesiology. 1990 Jul;73(1):1-4
references.pmid: 2141771
references.citation: Lancet. 2005 Sep 3-9;366(9488):809-17
references.pmid: 16139655
references.citation: J Clin Anesth. 2001 May;13(3):186-92
references.pmid: 11377156
references.citation: Anesthesiology. 1996 Jan;84(1):52-63
references.pmid: 8572354
references.citation: Anesthesiology. 1994 Dec;81(6):1365-70
references.pmid: 7992904
references.citation: Can J Anaesth. 2004 May;51(5):486-91
references.pmid: 15128636
references.citation: Korean J Anesthesiol. 2014 Apr;66(4):290-4
references.pmid: 24851164
references.citation: Br J Anaesth. 1993 Mar;70(3):273-5
references.pmid: 8471368
references.citation: Acta Anaesthesiol Scand. 1999 May;43(5):545-9
references.pmid: 10342003
references.citation: Anesthesiology. 2006 Mar;104(3):488-94
references.pmid: 16508396
references.citation: Anesthesiology. 1998 Mar;88(3):642-50
references.pmid: 9523807
references.citation: Anesthesiology. 1998 Oct;89(4):954-60
references.pmid: 9778013
references.citation: J Clin Monit. 1995 Mar;11(2):83-91
references.pmid: 7760092
references.citation: Anesth Analg. 1995 Apr;80(4):780-5
references.pmid: 7893035
references.citation: Anesthesiology. 1997 Apr;86(4):836-47
references.pmid: 9105228
references.citation: Stroke. 2010 Jul;41(7):1471-6
references.pmid: 20522817
references.citation: Br J Anaesth. 2001 Feb;86(2):209-12
references.pmid: 11573661
references.citation: J Clin Monit. 1993 Jul;9(3):176-85
references.pmid: 8345370
references.citation: Anesthesiol Clin. 2007 Sep;25(3):391-412, vii
references.pmid: 17884701
references.citation: Anesth Analg. 2005 Jan;100(1):4-10
references.pmid: 15616043
references.citation: Br J Anaesth. 2009 Mar;102(3):331-5
references.pmid: 19168857