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KMID : 1155520100050040304
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Anesthesia and Pain Medicine
2010 Volume.5 No. 4 p.304 ~ p.309
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Effect of remifentanil or esmolol on bispectral index and entropy to tracheal intubation during propofol anesthesia
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Choi Yoon-Ji
Shin Hye-Won
Kim Yun-Hee
Choi Sung-Wook
Park Ji-Yong
Yoon Seung-Zhoo
Chang Seong-Ho
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Abstract
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Background:The bispectral index (BIS) and entropy (response entropy, state entropy; RE, SE) have been used to monitor the anesthetic depth, and the difference between RE and SE (RE-SE difference) may represent the nociceptive stimuli during general anesthesia. This study was designed to determine whether BIS or entropy (RE, SE, and RE-SE difference) represent the response to tracheal intubation with iv bolus of remifentanil or esmolol for stable hemodynamic control during propofol anesthesia.
Methods:Eighty-nine patients were randomly divided into three groups (the control, esmolol, and remifentanil groups). Patient received propofol by target controlled infusion with air 2 L/min and O2 2 L/min. After the maintenance with target effect site concentration of propofol 5?g/ml for 5 min, patients received normal saline or esmolol 1.0 mg/kg or remifentanil 1.0?g/kg iv bolus according to group. And rocuronium 0.6 mg/kg iv bolus was administered and tracheal intubation was done. We measured mean arterial pressure (MAP), heart rate (HR), BIS, and entropy (RE, SE, RE-SE difference) during tracheal intubation.
Results:Changes in MAP or HR after tracheal intubation were greater in the control and esmolol groups than those in the remifentanil group. Although BIS, RE, and SE did not increase after intubation in all groups, but RE-SE difference significantly increased at 1 min after tracheal intubation in the control and esmolol group, but was unchanged in the remifentanil group.
Conclusions:Among BIS, RE, SE and RE-SE difference, RE-SE difference is the good indicator for estimate of nociception during tracheal intubation.
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KEYWORD
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Bispectral index, Entropy, Esmolol, Remifentanil, Propofol
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