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Influence of acute normovolaemic haemodilution on bispectral index monitoring and propofol dose requirements.
Acta Anaesthesiol Scand. 2008 Jul; 52(6):815-20.AA

Abstract

BACKGROUND

Numerous medical and physiological conditions that might alter electroencephalography (EEG), such as hypoglycaemia, hypothermia or hypovolaemia, were shown to result in the bispectral Index (BIS) indicating an incorrect hypnotic state. Recently, acute normovolaemic haemodilution (ANH) was shown to be associated with significant impairment of cognitive functions that could alter EEG and consequently BIS monitoring, an EEG derived parameter.

METHODS

In a randomised clinical study, we assessed the effect of ANH on BIS monitoring before induction and after propofol target controlled infusion (TCI) anaesthesia in 45 unmedicated patients randomly allocated to ANH with oxygen insufflation (oxygen group), ANH with air insufflation (air group), or control group.

RESULTS

With ANH, mean BIS values briefly declined in the oxygen group (82+/-4) and air group (84+/-3) before returning to baseline values. The loss of consciousness time was significantly shorter, with fewer propofol TCI dose requirements, and BIS was significantly higher in the oxygen group (1.3+/-0.5 min, 2.41+/-0.15 microg/ml, 73+/-7) and air group (1.2+/-0.6 min, 2.44+/-0.17 microg/ml, 75+/-5), compared with the control group (1.7+/-0.4 min, 2.75+/-0.17 microg/ml, 61+/-5), respectively. Whereas, there was no significant difference in BIS values between the oxygen group (38+/-7), air group (36+/-5) and control group (40+/-6) at propofol TCI 4 microg/ml anaesthesia maintenance.

CONCLUSIONS

BIS values briefly declined with ANH before returning to baseline values before anaesthesia induction. Despite transient ANH enhancement of propofol effect during induction, there was no significant difference in BIS values with or without ANH during propofol maintenance of anaesthesia.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria. ashraf.dahaba@meduni-graz.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18477087

Citation

Dahaba, A A., et al. "Influence of Acute Normovolaemic Haemodilution On Bispectral Index Monitoring and Propofol Dose Requirements." Acta Anaesthesiologica Scandinavica, vol. 52, no. 6, 2008, pp. 815-20.
Dahaba AA, Rinnhofer S, Wang G, et al. Influence of acute normovolaemic haemodilution on bispectral index monitoring and propofol dose requirements. Acta Anaesthesiol Scand. 2008;52(6):815-20.
Dahaba, A. A., Rinnhofer, S., Wang, G., Xu, X., Liu, X. Y., Wu, X. M., Rehak, P. H., & Metzler, H. (2008). Influence of acute normovolaemic haemodilution on bispectral index monitoring and propofol dose requirements. Acta Anaesthesiologica Scandinavica, 52(6), 815-20. https://doi.org/10.1111/j.1399-6576.2008.01629.x
Dahaba AA, et al. Influence of Acute Normovolaemic Haemodilution On Bispectral Index Monitoring and Propofol Dose Requirements. Acta Anaesthesiol Scand. 2008;52(6):815-20. PubMed PMID: 18477087.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of acute normovolaemic haemodilution on bispectral index monitoring and propofol dose requirements. AU - Dahaba,A A, AU - Rinnhofer,S, AU - Wang,G, AU - Xu,X, AU - Liu,X Y, AU - Wu,X M, AU - Rehak,P H, AU - Metzler,H, Y1 - 2008/05/12/ PY - 2008/5/15/pubmed PY - 2008/10/29/medline PY - 2008/5/15/entrez SP - 815 EP - 20 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 52 IS - 6 N2 - BACKGROUND: Numerous medical and physiological conditions that might alter electroencephalography (EEG), such as hypoglycaemia, hypothermia or hypovolaemia, were shown to result in the bispectral Index (BIS) indicating an incorrect hypnotic state. Recently, acute normovolaemic haemodilution (ANH) was shown to be associated with significant impairment of cognitive functions that could alter EEG and consequently BIS monitoring, an EEG derived parameter. METHODS: In a randomised clinical study, we assessed the effect of ANH on BIS monitoring before induction and after propofol target controlled infusion (TCI) anaesthesia in 45 unmedicated patients randomly allocated to ANH with oxygen insufflation (oxygen group), ANH with air insufflation (air group), or control group. RESULTS: With ANH, mean BIS values briefly declined in the oxygen group (82+/-4) and air group (84+/-3) before returning to baseline values. The loss of consciousness time was significantly shorter, with fewer propofol TCI dose requirements, and BIS was significantly higher in the oxygen group (1.3+/-0.5 min, 2.41+/-0.15 microg/ml, 73+/-7) and air group (1.2+/-0.6 min, 2.44+/-0.17 microg/ml, 75+/-5), compared with the control group (1.7+/-0.4 min, 2.75+/-0.17 microg/ml, 61+/-5), respectively. Whereas, there was no significant difference in BIS values between the oxygen group (38+/-7), air group (36+/-5) and control group (40+/-6) at propofol TCI 4 microg/ml anaesthesia maintenance. CONCLUSIONS: BIS values briefly declined with ANH before returning to baseline values before anaesthesia induction. Despite transient ANH enhancement of propofol effect during induction, there was no significant difference in BIS values with or without ANH during propofol maintenance of anaesthesia. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/18477087/Influence_of_acute_normovolaemic_haemodilution_on_bispectral_index_monitoring_and_propofol_dose_requirements_ L2 - https://doi.org/10.1111/j.1399-6576.2008.01629.x DB - PRIME DP - Unbound Medicine ER -