Tags

Type your tag names separated by a space and hit enter

Effects of epidural anesthesia with 0.2% and 1% ropivacaine on predicted propofol concentrations and bispectral index values at three clinical end points.
J Clin Anesth. 2006 Sep; 18(6):409-14.JC

Abstract

STUDY OBJECTIVE

To compare the effects of 0.2% epidural ropivacaine and those of 1% epidural ropivacaine on predicted propofol concentrations and bispectral index scores (BISs) at three clinical end points.

DESIGN

Randomized double-blind study.

SETTING

University hospital.

PATIENTS

Thirty-five (35) ASA physical status I and II patients scheduled for elective surgery of the lower abdomen.

INTERVENTIONS

Patients were randomly divided into 2 groups to receive epidurally 8 mL of 0.2% or 1% ropivacaine followed by the same solution at a rate of 6 mL/h.

MEASUREMENTS

Twenty minutes after starting ropivacaine, a target-controlled infusion of propofol was started to provide a predicted blood concentration of 3 microg/mL; it increased by 0.5 microg/mL every 60 seconds until all 3 clinical end points were reached, as follows: P1, when patients lost consciousness; P2, when patients failed to show pupillary dilation and skin vasomotor reflex to transcutaneous electric stimulation applied to the upper level of loss of cold sensation; and P3, when patients failed to show pupillary dilation and skin vasomotor reflex to transcutaneous electric stimulation applied to C5.

MAIN RESULTS

The effective concentration 50 values for both predicted blood and effect-site propofol concentrations were significantly larger in the 0.2% group than in the 1% group at all end points. The BIS at every end point was significantly smaller in the 0.2% group than in the 1% group.

CONCLUSIONS

During combined epidural-propofol anesthesia, unconsciousness and lack of response to noxious stimulation occurred at lower predicted concentrations with 1% epidural ropivacaine than with 0.2% epidural ropivacaine. The results also suggest that the BIS may not be a good indicator when propofol anesthesia is combined with epidural anesthesia.

Authors+Show Affiliations

Department of Anesthesiology, Shimane University School of Medicine, Izumo City 693-8501, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16980156

Citation

Kanata, Kazue, et al. "Effects of Epidural Anesthesia With 0.2% and 1% Ropivacaine On Predicted Propofol Concentrations and Bispectral Index Values at Three Clinical End Points." Journal of Clinical Anesthesia, vol. 18, no. 6, 2006, pp. 409-14.
Kanata K, Sakura S, Kushizaki H, et al. Effects of epidural anesthesia with 0.2% and 1% ropivacaine on predicted propofol concentrations and bispectral index values at three clinical end points. J Clin Anesth. 2006;18(6):409-14.
Kanata, K., Sakura, S., Kushizaki, H., Nakatani, T., & Saito, Y. (2006). Effects of epidural anesthesia with 0.2% and 1% ropivacaine on predicted propofol concentrations and bispectral index values at three clinical end points. Journal of Clinical Anesthesia, 18(6), 409-14.
Kanata K, et al. Effects of Epidural Anesthesia With 0.2% and 1% Ropivacaine On Predicted Propofol Concentrations and Bispectral Index Values at Three Clinical End Points. J Clin Anesth. 2006;18(6):409-14. PubMed PMID: 16980156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of epidural anesthesia with 0.2% and 1% ropivacaine on predicted propofol concentrations and bispectral index values at three clinical end points. AU - Kanata,Kazue, AU - Sakura,Shinichi, AU - Kushizaki,Hiroyuki, AU - Nakatani,Toshihiko, AU - Saito,Yoji, PY - 2005/10/07/received PY - 2005/11/24/revised PY - 2006/01/15/accepted PY - 2006/9/19/pubmed PY - 2006/10/27/medline PY - 2006/9/19/entrez SP - 409 EP - 14 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 18 IS - 6 N2 - STUDY OBJECTIVE: To compare the effects of 0.2% epidural ropivacaine and those of 1% epidural ropivacaine on predicted propofol concentrations and bispectral index scores (BISs) at three clinical end points. DESIGN: Randomized double-blind study. SETTING: University hospital. PATIENTS: Thirty-five (35) ASA physical status I and II patients scheduled for elective surgery of the lower abdomen. INTERVENTIONS: Patients were randomly divided into 2 groups to receive epidurally 8 mL of 0.2% or 1% ropivacaine followed by the same solution at a rate of 6 mL/h. MEASUREMENTS: Twenty minutes after starting ropivacaine, a target-controlled infusion of propofol was started to provide a predicted blood concentration of 3 microg/mL; it increased by 0.5 microg/mL every 60 seconds until all 3 clinical end points were reached, as follows: P1, when patients lost consciousness; P2, when patients failed to show pupillary dilation and skin vasomotor reflex to transcutaneous electric stimulation applied to the upper level of loss of cold sensation; and P3, when patients failed to show pupillary dilation and skin vasomotor reflex to transcutaneous electric stimulation applied to C5. MAIN RESULTS: The effective concentration 50 values for both predicted blood and effect-site propofol concentrations were significantly larger in the 0.2% group than in the 1% group at all end points. The BIS at every end point was significantly smaller in the 0.2% group than in the 1% group. CONCLUSIONS: During combined epidural-propofol anesthesia, unconsciousness and lack of response to noxious stimulation occurred at lower predicted concentrations with 1% epidural ropivacaine than with 0.2% epidural ropivacaine. The results also suggest that the BIS may not be a good indicator when propofol anesthesia is combined with epidural anesthesia. SN - 0952-8180 UR - https://www.unboundmedicine.com/medline/citation/16980156/Effects_of_epidural_anesthesia_with_0_2_and_1_ropivacaine_on_predicted_propofol_concentrations_and_bispectral_index_values_at_three_clinical_end_points_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(06)00112-7 DB - PRIME DP - Unbound Medicine ER -