Günhan GÖKAHMETOĞLU, Elvan TERCAN, Cihangir BİÇER, RECEP AKSU, Adem BOYACI

Comparison of the depth of anesthesia in sevoflurane and halothane anesthesia with bispectral index and 95% spectral edge frequency

Amaç: Bu çalışmanın amacı, bispektral indeks (BIS) ve % 95 spektral edge frekans (SEF) monitorizasyon sistemleri kullanarak, halotan ve sevofluran anestezi derinliklerinin değerlendirilmesidir. Yöntemler: 2001-2002 yılları arasında, yaşları 20 ile 60 arasında değişen, genel anestezi altında jinekolojik operasyon geçiren 40 hasta çalışmaya dahil edildi. Anestezi indüksiyonu Grup I hastalarda (n=20) halotan, Grup II hastalarda sevofluran ile konvansiyonel spontan inhalasyon indüksiyon metodu ile sağlandı. SEF ve BIS indeks değerleri kaydedildi. Bulgular: Her iki grupta entübasyon öncesi ve sonrası, cilt insizyon öncesi ve sonrası SEF değerleri, bazal de- ğerlerine göre anlamlı derecede düşüktü (p

Bispektral indeks ve %95 spektral edge frekans ile halotan ve sevofluran anestezi derinliklerinin karşılaştırılması

Objective: The aim of the present study was to evaluate the depth of anesthesia provided by halothane or sevoflurane by using the bispectral index (BIS) and 95% spectral edge frequency (SEF) monitoring systems. Methods: Forty patients, between the ages of 20-60 years, scheduled for gynecological surgery under general anesthesia were studied between the years 2001-2002. Anesthesia induction was maintained by conventional spontaneous inhalation induction method with sevoflurane in the group I patients (n=20), with halothane in the group II patients (n=20). SEF and BIS index values were recorded. Results: In both groups, SEF values recorded before intubation, after intubation, before and after skin incision were significantly lower compared with values recorded at baseline (p<0.05). Also, SEF values in both groups recorded after anesthesia induction were significantly higher compared with baseline values (p<0.05). Regarding the recorded SEF values after extubation, there were statistically significant differences between the two groups (p<0.05). In both groups, BIS values recorded after anesthesia induction, before intubation, after intubation, before and after skin incision were significantly lower compared with values recorded at baseline and after extubation (p<0.05). Regarding the recorded BIS values before intubation and 1 min after intubation, there were statistically significant differences between the two groups (p<0.05). Conclusion: We conclude that BIS index and SEF values will only be helpful in the evaluation of the hypnosis component of anesthesia and it is not sufficient in showing the autonomous response, which is formed against the perioperative sympathetic and surgical stimulations.

PDF

___

1. Rosow C, Manberg PJ. Bispectral index monitoring. Anesth Clin N Am 1998;2:89-107.
2. Stanski DR. Monitoring depth of anesthesia. In: Miller RD (ed), Anesthesia. Churchill Livingstone Inc, New York 2000, pp 1087-1116.
3. Pino RM, Ali HH, Denman WT, et al. A comparison of the intubation conditions between mivacurium and rocuronium during balanced anesthesia. Anesthesiology 1998;88:673- 678.
4. Ruffle JM, Snider MT, Rosenberger JL, et al. Rapid induction of halothane anaesthesia in man. Br J Anaesth 1985;57:607-611.
5. Muzi M, Robinson BJ, Ebert TJ, et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996;85:536-543.
6. Jellish WS, Lien CA, Fontenot HJ, et al. The comparative effects of sevoflurane versus propofol in the induction and maintenance of anesthesia in adult patients. Anesth Analg 1996;82:479-485.
7. Ruffle JM, Snider MT. Comparison of rapid and conventional inhalation inductions of halothane oxygen anesthesia in healthy men and women. Anesthesiology 1987;67:584-587.
8. Drummond GB. Rapid inhalation induction of anaesthesia. Br J Anaesth 1988;61:373-375.
9. Smith I, Nathanson M, White PF. Sevoflurane a long awaited volatile anaesthetic. Br J Anaesth 1996;76:435-445.
10. Oğuz S, Özalp G, Özmert G, et al. Sevofluran ile anestezi indüksiyonunda klasik spontan inhalasyon indüksiyon yöntemi ile tek vital kapasite soluması yöntemlerinin karşılaştırılması. Türk Anesteziyoloji ve Reanimasyon Cemiyeti Mecmuası 1998;26:130-133.
11. Stern R, Towler S, White P, et al. Elimination kinetics of sevoflurane and halothane from blood, brain and adipose tissue in the rat. Anesth Analg 1990;7:237-244.
12. Yasuda N, Lockhart SH, Eger II EI, et al. Comparison of kinetics of sevoflurane and isoflurane in humans. Anesth Analg 1991;72:316-324.
13. Yurino M, Kimura H. Vital capacity breathing respiration technique for rapid anaesthetic induction comparison of sevoflurane and isoflurane. Anaesthesia 1992;47:946-949.
14. Immamura S, Ikeda K. Comparison of the epinephrine induced arrhytmogenic effect of sevoflurane and halothane. J Anaesth 1987;1:62-68.
15. Tanaka S, Tsuchida H, Nakabayashi K-I, et al. The effects of sevoflurane, isoflurane, halothane and enflurane on haemodynamic responses during an inhaled induction of anesthesia a mask in humans. Anesth Analg 1996;82:821-826.
16. Hall J, Ebert TJ, Harmer M. Induction characteristics with 3% and 8% sevoflurane in adults: An evaluation of the second stage of anaesthesia and its haemodynamic consequences. Anaesthesia 2000;55:545-550.
17. Glass PS, Bloom M, Kearse L, et al. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane and alfentanil in healthy volunteers. Anesthesiology 1997;86:836-847.
18. Flaishon R, Windsor A, Sigl J, et al. Recovery of consciousness after thiopental or propofol: BIS and the isolated forearm technique. Anesthesiology 1997;86:613-619.
19. Schwender D, Daunderer M, Mulzar S, et al. Spectral edge frequency of the electroencephalogram to monitor depth of anaesthesia. Br J Anaesth 1996;77:179-184.
20. Sawtelle K, Rampil I. Bispectral EEG index predicts awakening. Anesthesiology 1994;81:A213.