Comparison of Bispectral Index at Each Thiopental Sodium Induction Dose / 대한마취과학회지

BACKGROUND: Thiopental sodium is one of the most commonly used intravenous anesthetics, but there exists no reliable report of BIS that can predict the hypnotic state. Our purpose was to compare BIS values after administering different doses of thiopental sodium. METHODS: With institutional review board approval and informed consent, sixty adult patients scheduled for elective surgery were studied. The patients were divided into three groups according to induction doses as follows: group 1: 3 mg/kg, group 2: 4 mg/kg, group 3: 5 mg/kg. After induction the BIS was monitored at 15 second intervals to 90 seconds. The number of patients with a BIS of less than 55 was recorded. RESULTS: The BIS at baseline and 15 seconds after administration were not statistically different in the three groups. The BIS at 30 seconds in group 1 differed from those of groups 2 and 3, but all of the mean BIS values were more than 55. The BIS values at 45 and 90 seconds were statistically different for three groups, and the mean BIS values of groups 2 and 3 were less than 55. The number of patients with a BIS of less than 55 at any point was eight in group 1, and twenty in groups 2 and 3. CONCLUSIONS: BIS monitoring suggests that a dosage above 4 mg/kg of thiopental sodium is sufficient for the reliable induction of anesthesia.

Anesthetic Management during Aortic Arch Surgery Using Anterograde Selective Cerebral Perfusion / 대한마취과학회지

Cerebral protection during aortic arch surgery is an anesthetic challenge, since the surgical procedures for aortic arch aneurysm involve an interruption of cerebral blood flow. We report a successfully managed case of aortic arch aneurysm repair with antegrade selective cerebral perfusion (SCP) during TCA (total circulatory arrest) using a transcranial oximeter, cerebral oxygenation was monitored during surgery. Although at the beginning of TCA a decrease in the regional cerebral oxygen saturation was observed, this was soon recovered by SCP. Except for the short period of TCA without SCP, regional cerebral oxygen saturation (rSO2) value were well maintained during surgery.

The Clinical Experience of Propofol-Alfentanil Anesthesia Using Computer Assisted Continuous Infusion / 대한마취과학회지

The short duration and fast onset of action of alfentanil underpins its suitability for use in anesthetic techniques. In these case studies, we have assessed the efficacy, safety and feasibility of alfentanil as an analgesic adjuvant of propofol based general anesthesia. Propofol was titrated to Keep the bispectral index in the 40 50 range. Alfentanil was infused at the effect site concentration of 80 or 160 ng/ml using a computer assisted continuous infusion. Two patients in this pilot study showed stable hemodynamics, smooth emergence and satisfactory postoperative pain control with additional analgesics in PACU.