These results suggest that a single bolus of 1 microg kg(-1) remifentanil effectively attenuates haemodynamic but not BIS responses to tracheal intubation in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. However, its use was associated with maternal hypotension and neonatal respiratory depression requiring resuscitation.

Background:We examined the effects of different anesthetics on cerebral oxygenation and systemic hemodynamics in patients undergoing surgery in beach chair position (BCP). Jugular venous bulb oxygen saturation (SjvO 2 ) and regional cerebral tissue oxygen saturation (SctO 2 ) were determined while patients were placed from the supine to BCP. Whether SctO 2 and SjvO 2 are interchangeable in assessing the cerebral oxygenation was also examined. Methods: Forty patients undergoing shoulder surgery in BCP were randomly assigned to receive sevoflurane-nitrous oxide (S/N) or propofol-remifentanil (P/R) anesthesia. Four patients taking angiotensin II receptor antagonists were excluded post hoc. Mean arterial pressure and heart rate, as well as SjvO 2 and SctO 2 , were measured before (postinduction baseline in supine position) and after BCP. Results: Mean arterial pressure decreased by BCP in both groups. It was, however, significantly higher in S/N (n ϭ 19) than in P/R group (n ϭ 17) at 7 to 8 min after the positioning. SjvO 2 also significantly decreased after BCP in both groups, the magnitude of which was lower in S/N than in P/R group (11 Ϯ 10% vs. 23 Ϯ 9%, P ϭ 0.0006). The incidences of SjvO 2 Ͻ50% and mean arterial pressure less

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