Nitrous oxide does not alter bispectral index: study with nitrous oxide as sole agent and as an adjunct to i.v. anaesthesia

Barr, G.; Jakobsson, Jan; Öwall, Anders; Anderson, R. E.

doi:10.1093/bja/82.6.827

Cited by 181 publications

(100 citation statements)

References 16 publications

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“…Similar observations that up to 66% N 2 O does not alter the BIS have also been reported. 19 Studies have shown that opioids, 20 as well as nitrous oxide, do not affect BIS values when correlated with drug concentrations and clinical responses.…”

Section: Discussionmentioning

confidence: 99%

Ľindex bispectral et la saturation en oxygène du sang cérébral régional pendant ľanesthésie au propofol/N2O

Kanemaru

Nishikawa

Goto

2006

Can J Anesth/J Can Anesth

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Purpose:A study was undertaken to compare the influence of midazolam, isoflurane, and aminophylline (which may antagonize anesthetic action) on bispectral index (BIS) and regional cerebral oxygen saturation (rSO 2 ) during propofol/N 2 O anesthesia, and to test the hypothesis that the drug-induced changes in BIS values are accompanied by a change in rSO 2 .Methods: General anesthesia was administered to 36 patients with a continuous infusion of propofol to maintain a BIS value of 40 ± 5. After baseline recordings, patients were randomly assigned to receive either midazolam, isoflurane, or aminophylline. Bispectral index values, rSO 2 using near-infrared spectroscopy, and hemodynamic parameters were recorded for 60 min.Results: Midazolam (0.05 mg·kg -1 ) significantly decreased the BIS from 47.8 ± 5.4 to 35.0 ± 4.5 at five minutes after injection (P < 0.001 vs control) during propofol anesthesia, whereas the rSO 2 was unchanged. Similarly, isoflurane (1.1% end-tidal) decreased the BIS from 42.5 ± 7.5 to 27.8 ± 6.9 (P < 0.001) without affecting rSO 2 . In contrast, aminophylline (3 mg·kg -1 ) was associated with an increase in BIS from 41.6 ± 2.1 to 48.3 ± 9.2 at five minutes after injection (P < 0.05) without affecting rSO 2 .Conclusions: Midazolam or isoflurane-induced decreases in the BIS during propofol anesthesia were not accompanied by a decrease in rSO 2 . Aminophylline significantly increased the BIS score during propofol anesthesia, suggesting that aminophylline can antagonize, at least in part, the sedative actions of propofol. 47,8 ± 5,4 à 35,0 ± 4,5 cinq minutes après l'injection (P < 0,001 vs témoin) pendant l'anesthésie au propofol, tandis que la rSO 2 n'a pas changé. De même,1,1 %) a diminué le BIS de 42,5 ± 7,5 à 27,8 ± 6,9 (P < 0,001) Objectif : Comparer l'influence du midazolam, de l'isoflurane et de l'aminophylline (qui peut contrer l'action anesthésique) sur l'index bispectral (BIS) et

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Section: Discussionmentioning

confidence: 99%

Ľindex bispectral et la saturation en oxygène du sang cérébral régional pendant ľanesthésie au propofol/N2O

Kanemaru

Nishikawa

Goto

2006

Can J Anesth/J Can Anesth

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“…We think that the number of the patients should be greater to detect a difference in induction time. Also, the concentrations of F A /F a not been measured might (23)(24)(25)(26)(27)(28)(29). There are hypotheses that the reason of this is related to N 2 O changing the beta ratio in BIS (the ratio of very high beta activity to the sum of high alpha and beta activities) (23).…”

Section: Discussionmentioning

confidence: 99%

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

Erel¹,

Gürsoy²,

Kurt³

et al. 2018

meandros

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ÖzAmaç: İnhalasyon indüksiyonu sırasında azot protoksit gazının (N 2 O) sevofluranın vücuda alınması sürecinin hızı ve kalitesi üzerindeki etkilerini araştırmaktır. Gereç ve Yöntemler: Jinekolojik müdahale yapılması planlanan Amerikan Anestezistler Derneği kriterlerine göre I-II grubunda 84 kadın hasta randomize edilerek iki gruba ayrıldı. Tek soluk indüksiyonu yöntemi ile anestetize edilen hastalarda birinci gruba [Grup sevoflurane and azot protoksit (SA)] indüksiyonda %8 sevofluran, %67 azot protoksit ve %33 oksijen, ikinci gruba [Grup sevofluran (S) ve azot protoksit] %8 sevofluran ve %100 oksijen uygulandı. İndüksiyon sırasında oksijen, karbondioksit ve sevofluranın end-tidal ve inspiratuvar yoğunlukları, kirpik refleksinin kaybolmasına kadar geçen süre, gözlerin orta hatta gelmesi AbstractObjective: To determine the effects of nitrous oxide (N 2 O) on the speed and quality of the uptake process of sevoflurane during inhalation induction in adult patients. Materials and Methods: For randomized controlled study, eighty-four American Society of Anesthesiologists I-II patients undergoing gynecological interventions were randomly assigned to receive an 8% sevoflurane mixture with either 67% N 2 O plus 33% oxygen [Group sevoflurane and nitrous oxide (SA)] or 100% oxygen only [Group sevoflurane (S)]. Both groups were induced by a single-breath induction. End-tidal and inspiratory concentrations of respiratory and anesthetic gasses were continuously assessed during induction as well as time to loss of eyelash reflex, time to cessation of eye movements, and time to initiation of spontaneous breaths. Patients were intubated by the 5 th minute of induction and their vital signs, bispectral indexes, reflex responses to intubation and additional drug requirements for intubation were also recorded. Results: End-tidal sevoflurane concentrations and the ratio of alveolar to inspiratory sevoflurane concentrations (F A /F i ) of patients in group SA recorded at the 2 nd , the third and the 5 th minute of induction showed statistically significant increases when compared with patients in group S. Time to loss of eyelash reflex and time to cessation of eye movements were found to be decreased in group SA by 25 and 13%, respectively. Patients who presented with a reflex response to intubation in group S exceeded patients in group SA by 38.8% and patients who required additional medication for intubation in group S exceeded patients in group SA by 28.6%. Conclusion: The findings of this study support the view that administration of N 2 O improves the rate and quality of mask induction with sevoflurane. The benefits provided by N 2 O attributable to the concentrating and second gas effects appear during the first few minutes of induction (2 nd , 3 rd , and 4 th minutes) as well as during intubation when sevoflurane is used for mask induction.

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“…В ряде исследований показано, что BIS-алгоритм, эмпирически основанный на ЭЭГ при использовании «ГАМК-ергических» гипнотиков (пропофол), не всегда корректен в отношении общих анестетиков с NMDA-антагонистичными свойствами: кетамина, N2O, α2-адренергических агонистов [15,20,21]. В других литературных источниках указывается на значимое соответствие BIS и клинической картины анестезии ксеноном [11,2,10].…”

Section: Bis-monitoring Use For the Anesthesia And Sedation Level Conunclassified

Bis-Monitoring Use for the Anesthesia and Sedation Level Control During Xenon Anesthetic Support in Ophthalmosurgery

Myasnikova¹,

Sakhnov²,

Klokova³

et al. 2016

СПНО (MPSE)

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BIS-MONITORING USE FOR THE ANESTHESIA AND SEDATION LEVEL CONTROL Krasnodar,.ru BIS-index data were examined in 19 ophthalmic patients during general combined xenon anesthesia and in 12 patients during xenon analgosedation before excimer laser operations. Systolic blood pressure, heart rate, SatO2 and etCO2; BIS-index were monitored. Hemodynamic and ventilation data were stable. In the 1st group xenon (50-55 %) was connected after anesthesia induction, BIS-potential decreased up to 24 units. At the next stages BIS-index ranged from 40 to 60 units. However, during the first 20 minutes 40% of patients had higher BISindex level. In the 2nd patients group analgosedation was performed by oxygen-xenon mixture mask ventilation (Xe 35-40 %), with 20 minutes exposure. BIS-index decreased up to 72 %, mioplegia level up to 70 %. 1/3 of the patients had mild symptoms of euphoria. By the 20th minute patients were sedated, fell asleep, initially high blood pressure and heart rate were decreased. Consciousness was fully recovered in 2-3 minutes after the session termination. Topical-anesthesia was performed, the patient was calm and ready for the operation. BIS-index significantly improves anesthesia quality and safety, making the control more objective. The fact that almost half of the patients have BIS-index decrease with 10-15 minutes delay must be taken into consideration while general anesthesia use.

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Nitrous oxide does not alter bispectral index: study with nitrous oxide as sole agent and as an adjunct to i.v. anaesthesia

Cited by 181 publications

References 16 publications

Ľindex bispectral et la saturation en oxygène du sang cérébral régional pendant ľanesthésie au propofol/N2O

Ľindex bispectral et la saturation en oxygène du sang cérébral régional pendant ľanesthésie au propofol/N2O

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

Bis-Monitoring Use for the Anesthesia and Sedation Level Control During Xenon Anesthetic Support in Ophthalmosurgery

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