Effects of preanesthetic single administration of dexmedetomidine on the remifentanil and propofol requirement during laparoscopic cholecystectomy

BACKGROUND: Dexmedetomidine, an α2-adrenergic agonist, can be used for sedation and as an adjuvant to anesthetics. This study aimed to evaluate the effects of preanesthetic administration of dexmedetomidine on the propofol and remifentanil requirement during general anesthesia and postoperative pain in patients undergoing laparoscopic cholecystectomy. METHODS: Sixty patients were randomly assigned to group D or S (n = 30 each). Dexmedetomidine (0.5 µg/kg) and a comparable volume of saline were administered in groups D and S, respectively, over a 10 minutes period before induction. General anesthesia was induced and maintained with propofol and remifentanil; the bispectral index was maintained at 40–60. The intraoperative remifentanil and propofol dosages were recorded, and postoperative pain was assessed using a visual analog scale (VAS). RESULTS: In groups S and D, propofol dosage was 8.52 ± 1.64 and 6.83 ± 1.55 mg/kg/h, respectively (P < 0.001), while remifentanil dosage was 7.18 ± 2.42 and 4.84 ± 1.44 µg/ kg/h, respectively (P < 0.001). VAS scores for postoperative pain were 6.50 (6–7) and 6.0 (6–7), respectively, at 30 minutes (P = 0.569), 5 (4–5) and 4 (3–5), respectively, at 12 hours (P = 0.039), and 2 (2–3) and 2 (1.25–2), respectively, at 24 hours (P = 0.044). The Friedman test revealed that VAS scores changed over time in both groups (P < 0.001). CONCLUSIONS: Preanesthetic single administration of a low dose of dexmedetomidine (0.5 µg/kg) can significantly decrease the remifentanil and propofol requirement during short surgeries and alleviate postoperative pain.

Anesthetic experience of a patient with Prune-belly syndrome / 대한마취과학회지

No abstract available.

Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients / 대한마취과학회지

BACKGROUND: Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used. METHODS: A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room. RESULTS: In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 +/- 11.8 vs 41.0 +/- 7.0, S group 59.2 +/- 17.6 vs 36.4 +/- 7.3, SM group 58.3 +/- 17.5 vs 26.0 +/- 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01). CONCLUSIONS: The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.

Seizure developed after palonosetron intravenous injection during recovery from general anesthesia: A case report / 대한마취과학회지

Seizure associated with antiemetics is rare. We report seizure associated with a 5-HT3 receptor antagonist in a 38 years old female. The patient underwent ureterorenoscopic lithotripsy due to left upper ureter stone. After operation, the patient complained of nausea in the postanesthetic recovery unit. In order to subside symptom, the patient was administrated 5-HT3 receptor antagonist, palonosetron, 0.075 mg intravenously. Shortly after administration of that, the patient developed generalized tonic-clonic seizures. The symptom was subsided after midazolam and thiopental sodium were injected. But 40 minutes later, seizure recurred and subsided with midazolam again. The patient recovered completely without any specific sequelae.

Cedrol Enhances Extracellular Matrix Production in Dermal Fibroblasts in a MAPK-Dependent Manner

BACKGROUND: The extracellular matrix (ECM) produced by dermal fibroblasts supports skin structure, and degradation and/or reduced production of ECM are the main causes of wrinkle formation. OBJECTIVE: The aim of this study was to identify the active ingredient that enhances ECM production in dermal fibroblasts. METHODS: Polarity-based fractionation was used to isolate the active ingredient from natural extracts, and the effects of cedrol (isolated from Pterocarpus indicusirginia) on ECM production in cultured human dermal fibroblasts was investigated by reverse transcription-polymerase chain reaction, enzyme linked immunosorbent assay, and Western blot analysis. RESULTS: Cedrol accelerated fibroblast growth in a dose-dependent manner and increased the production of type 1 collagen and elastin. Phosphorylation of p42/44 extracellular signal-regulated kinase, p38 mitogen-activated protein kinase, and Akt was markedly increased by cedrol, indicating that enhanced ECM production is linked to activation of intracellular signaling cascades. CONCLUSION: These results indicate that cedrol stimulates ECM production, with possible applications to the maintenance of skin texture.

Fluoroscope guided epidural needle insertioin in midthoracic region: clinical evaluation of Nagaro's method / 대한마취과학회지

BACKGROUND: In the midthoracic region, a fluroscope guided epidural block has been proposed by using a pedicle as a landmark to show the height of the interlaminar space (Nagaro's method). However, clinical implication of this method was not fully evaluated. We studied the clinical usefulness of a fluoroscope guided thoracic epidural block in the midthoracic region. METHODS: Twenty four patients were scheduled to receive an epidural block at the T6-7 intervertebral space. The patients were placed in the prone position. The needle entry point was located at the junction between midline of the pedicle paralleled to the midline of the T7 vertebral body (VB) and the lower border of T7 VB on anteroposterior view of the fluoroscope. The needle touched and walked up the lamina, and the interlaminar space (ILS) was sought near the midline of the VB at the height of the pedicle. RESULTS: The authors could not insert an epidural needle at T6-7 ILS in two patients and it was instead inserted at T5-6 ILS. However, other patients showed easy insertion at T6-7 ILS. The mean inward and upward angulations were 25degrees and 55degrees respectively. The mean actual depth and calculated depth from skin to thoracic epidural space were 5.1 cm and 6.1 cm respectively. Significant correlation between actual needle depth and body weight, podendal index (kg/m) or calculated needle depth was noted. CONCLUSIONS: The fluorposcope guided epidural block by Nagaro's method was useful in the midthoracic region. However, further study for the caudal shift of needle entry point may be needed.

The antiemetic effect of midazolam or/and ondansetron added to intravenous patient controlled analgesia in patients of pelviscopic surgery / 대한마취과학회지

BACKGROUND: We made a comparative study on the antiemetic effect of midazolam and ondansetron added to intravenous patient-controlled analgesia (PCA) using fentanyl with gynecologic patients undergoing pelviscopic surgery. METHODS: The PCA using 20 microg/kg of fentanyl was started in all groups postoperatively. A dose of 16 mg of ondansetron was added to the PCA of group O (n = 30). A dose of 5 mg of midazolam was added to the PCA of group M (n = 30). While 16 mg of ondansetron and 5 mg of midazolam were added to the PCA of group MO (n = 30). Total volume of the PCA was 60 ml, and the PCA system was programmed to deliver 0.5 ml/h of continuous doses and a 0.5 ml bolus on demand, with a 15 minutes lockout interval. The incidence of postoperative nausea and vomiting (PONV), sedation score, visual analog scale (VAS) for pain, and rescue drug dose for PONV were investigated at the postanesthesia care unit (PACU), 6 hours, and 24 hours after recovery. RESULTS: The incidence of PONV in group MO was significantly lower than in group O at PACU, 24 hours after recovery (P < 0.05). The sedation score and VAS pain score showed no differences among all groups. CONCLUSIONS: Midazolam added to PCA using fentanyl proved more effective than ondansetron in preventing PONV without adverse effects.

Distance from the lumbar epidural space to the skin in Korean adults

BACKGROUND: Lumbar epidural block is a common regional anesthetic/analgesic technique. The depth of the epidural space beneath the skin surface varies from patient to patient at the same vertebral level. It also varies at different levels of the spinal column in the same patient. This study was performed to evaluate the correlations between the lumbar epidural depth and physical measurements depending on the puncture site. METHODS: Data was gathered from 1,653 patients who were undergoing elective lumbar epidural blocks for anesthesia during surgical procedures. The age, gender, height and weight were obtained from the medical records. We calculated the physical parameters such as the weight/height ratio, the body mass index (BMI) and Broca's index. Pearson's correlation analysis and regression testing between the lumbar epidural depth and the physical measurements were performed. RESULTS: The epidural depths at the L2-3, L3-4, L4-5 and L5-S1 intervertebral space were 4.4 +/- 0.62, 4.6 +/- 0.69, 4.6 +/- 0.69 and 4.1 +/- 0.52 cm, respectively. A significant correlation was found between the epidural depth and the weight/height ratio and BMI. CONCLUSIONS: The weight/height ratio and BMI showed the highest correlation with the lumbar epidural depth.

Optimal dose of fentanyl for the prevention of emergence agitation after desflurane anesthesia in children undergoing tonsillectomy

BACKGROUND: Emergence agitation frequently occurs after desflurane anesthesia in children. We designed this study to find the optimal dose of fentanyl for the prevention of emergence agitation after desflurane anesthesia in children for tonsillectomy. METHODS: Eighty-one patients (3-10 yr) receiving desflurane anesthesia for tonsillectomy was randomly allocated to one of 3 groups. Fentanyl 1 microg/kg (group 1, n = 26), 2 microg/kg (group 2, n = 27), 3 microg/kg (group 3, n = 28) was administered intravenously just before inducing anesthesia. Anesthesia was maintained with desflurane. The recovery characteristics, such as the time to first movement, extubation and discharge from the recovery room were assessed. And patients reported their frequency of emergence agitation and severity of postoperative pain at recovery room. RESULTS: There were no significant differences between the three groups regarding the time to extubation and discharge from the recovery room. The incidence of emergence agitation was 42% in group 1, 25% in group 2, 10% in group 3 and that was significantly lower in group 3 than in group 1 (P < 0.05). The incidence of severe pain was lower in group 3 than in group 1 and group 2 (P < 0.05). CONCLUSIONS: In children undergoing tonsillectomy with desflurane anesthesia, 2 microg/kg and 3 microg/kg of fentanyl given just before induction had a reduced incidence of emergence agitation without a delay in recovery.

Pneumomediastinum and pneumothorax after orthognathic surgery: A case report / 대한마취과학회지

The occurrences of pneumomediastinum and pneumothorax after oral and/or maxillofacial surgery are rare, but both are potentially life-threatening complications. Most of the cases that present pneumomediastinum and pneumothorax in the oral and/or maxillofacial surgery result from air dissecting down the fascial planes of the neck. We report a case of a 23-year-old male patient who underwent bilateral sagittal split ramus osteotomy under general anesthesia and developed pneumomediastinum and pneumothorax without any traumatic introduction of air through the cervical fascia three days postoperatively. The possible causes and its prevention are discussed with a review of the relevant literature.

The clinical effectiveness of the streamlined liner of pharyngeal airway (SLIPA(TM)) compared with the laryngeal mask airway ProSeal(TM) during general anesthesia / 대한마취과학회지

BACKGROUND: The aim of this study was to compare the streamlined liner of the pharynx airway (SLIPA), a new supraglottic airway device (SGA), with the laryngeal mask airway ProSeal(TM) (PLMA) during general anesthesia. METHODS: Sixty patients were randomly allocated to two groups; a PLMA group (n = 30) or a SLIPA group (n = 30). Ease of use, first insertion success rate, hemodynamic responses to insertion, ventilatory efficiency and positioning confirmed by fiberoptic bronchoscopy were assessed. Lung mechanics data were collected with side stream spirometry at 10 minutes after insertion. We also compared the incidence of blood stain, incidence and severity of postoperative sore throat and other complications. RESULTS: First attempt success rates were 93.3% and 73.3%, and mean insertion time was 7.3 sec and 10.5 sec in PLMA and SLIPA. There was a significant rise in all of hemodynamic response from the pre-insertion value at one minute following insertion of SLIPA. But, insertion of PLMA was no significant rise in hemodynamic response. There was no statistically significant difference in the mean maximum sealing pressure, gas leakage, lung mechanics data, gastric distension, postoperative sore throat and other complication between the two groups. Blood stain were noted on the surface of the device in 40% (n = 12) in the SLIPA vs. 6.7% (n = 2) in the PLMA. CONCLUSIONS: The SLIPA is a useful alternative to the PLMA and have comparable efficacy and complication rates. If we acquire the skill to use, SLIPA may be considered as primary SGA devices during surgery under general anesthesia.

Stimulation of the Extracellular Matrix Production in Dermal Fibroblasts by Velvet Antler Extract

BACKGROUND: Fibroblasts produce many components of the extracellular matrix (ECM) and so they contribute to the maintenance of connective tissue integrity. OBJECTIVE: The aim of this study is to evaluate the effect of velvet antler extract (VAE) on the ECM production of dermal fibroblasts cultured in vitro. METHODS: Primary cultured human dermal fibroblasts were treated with VAE, and then the ECM production was determined by RT-PCR, ELISA and Western blot analysis. Furthermore, the change of gene expression according to VAE treatment was evaluated by cDNA microarray. RESULTS: VAE accelerated the growth of fibroblasts in a dose-dependent manner. VAE increased the production of several ECM components, including type 1 collagen, fibronectin and elastin. In line with these results, the phosphorylations of p42/44 ERK and p38 mitogen-activated protein kinase were markedly increased by VAE, suggesting that the enhancement of ECM production may be linked to the activation of intracellular signaling cascades. VAE also significantly increased cell migration on an in vitro scratch wound test. In cDNA microarray, many genes related with connective tissue integrity were identified to be up-regulated by VAE. CONCLUSION: These results suggest that VAE has a potential to stimulate ECM production, and VAE may be applicable for maintaining the skin's texture.

Intraperitoneal Ropivacaine Instillation for Postoperative Pain Relief after Laparoscopic Cholecystectomy

PURPOSE: A study was designed to assess the effect of intraperitoneal instillation of ropivacaine in larparoscopic cholecystectomy patients using computerized patient controlled anesthesia (PCA). METHODS: From January 2009 to June 2009, 40 patients with uncomplicated, symptomatic cholecystitis with cholelithiasis who were referred to Chung-Ang University Medical Center for laparoscopic cholecystectomy were included in the study. Patients in group C (control group) received normal saline 100 ml and those in group I (instillation group) received intraperitoneal instillation of 2 mg/kg of ropivacaine diluted in 100 ml saline at the initiation of pneumoperitoneum. Patients were assessed for pain by blinded investigators at 6 time intervals after surgery; 2 hr, 4 hr, 8 hr, 12 hr, 24 hr, and 48 hr. The frequency at which patients pushed the button of the PCA on bolus requirement (FPB) was assessed by a patient-controlled module on the PCA machine. RESULTS: The mean total fentanyl consumption was lower in group I (367.39+/-85.88) than in group C (535+/-100.29) during the 48 hours (P<0.001). Fentanyl velocity and FPB showed significant difference between the groups (P<0.005). Visual analogue scale (VAS) measured pain scores were significantly lower in group I than in group C at 4 hr (P=0.027), 8 hr (P=0.010), 12 hr (P=0.011). CONCLUSION: Intraperitoneal instillation of ropivacaine at the beginning of laparoscopic cholecystectomy (LC) combined with normal saline infusion is an effective method for reducing pain after LC.

The Effects of Remifentanil on Hemodynamic Changes in Endotracheal Intubation during Rapid Sequence Induction using Thiopental-succinylcholine or Propofol-succinylcholine / 대한마취과학회지

BACKGROUND: This study evaluated the effects of remifentanil on hemodynamic changes in endotracheal intubation during rapid sequence induction using thiopental or propofol and succinylcholine. METHODS: One hundred and twenty patients were divided into 4 groups (30 patients in each group).Anesthesia was induced with propofol 2 mg/kg or thiopental 5 mg/kg and succinylcholine 1 mg/kg followed by remifetanil 0.5microgram/kg (group PR), remifentanil 1microgram/kg (group TR) or normal saline as control (group PC, group TC).An endotracheal intubation was performed 90 s later, and vecuronium 0.08 mg/kg was given for neuromuscular block.Anesthesia was maintained using 1-3 vol% enflurane with 2 L/min N2O and 2 L/min O2.Arterial blood pressure (ABP) and heart rate (HR) were recorded before induction, just before intubation, and at 1 min intervals for 5 min after intubation.The incidence of hypertension, hypotension, tachycardia, and bradycardia were recorded. RESULTS: ABP in group PR was lower than in group TR, but HR was not different.The incidence of hypotension in group PR was higher than group TR or group PC.ABP in groups using remifentanil was lower than in control groups.The incidence of hypertension and tachycardia in groups using remifentanil were lower than control groups. CONCLUSIONS: During administration of propofol or thiopental and succinylcholine, remifentanil as a bolus for rapid sequence induction attenuated cardiovascular responses to endotracheal intubation effectively, but with a higher incidence of hypotension following propofol.

The effects of continuous infusion of ondansetron on postoperative nausea and vomiting in patients receiving IV-patient controlled analgesia following gynecological surgery / 대한마취과학회지

BACKGROUND: This study was designed to evaluate the effects of continuous infusion of ondansetron on postoperative nausea and vomiting (PONV) in patients receiving intravenous patient controlled analgesia (IV-PCA) following laparoscopic gynecological surgery. METHODS: Sixty ASA class I and II patients scheduled for gynecological laparoscopic surgery were randomly divided into the following 3 groups that received the specified dosages of ondansetron mixed with IV-PCA: placebo (group 1), ondansetron 8 mg (group 2), ondansetron 16 mg (group 3). The incidences of nausea, vomiting, visual analogue scale (VAS), and side effects were then recorded in the recovery room, 24 h, 48 h and 72 h postoperatively. RESULTS: There were no significant differences in the occurrence of nausea between group 1 and 2. However, the incidence of nausea in group 3 was significantly lower than in group 1 at 24 h and 48 h after surgery. In addition, significant differences in the occurrence of vomiting were observed among the three groups. However, with the exception of pruritus, no side effects were observed in any of the groups. CONCLUSIONS: IV-PCA mixed with 16 mg of ondansetron effectively prevented nausea at 24 h and 48 h after gynecologic laparoscopic surgery.

Comparison between Remifentanil and Nicardipine with Esmolol Continuously Infused for Attenuation of Hemodynamic Changes during Total Knee Arthroplasty in Elderly Patient / 대한마취과학회지

BACKGROUND: The use of tourniquet is associated with severe hemodynamic changes, particularly in elderly patients. This study examined the effects of continuously infused remifentanil or nicardipine with esmolol on the attenuation of the hemodynamic changes with enflurane inhalation during total knee arthroplasty in elderly patients. METHODS: Thirty elderly female patients undergoing total knee arthroplasty were enrolled into this randomized, prospective study. Remifentanil (group R) or nicardipine with esmolol (group EN) was infused using a titration method to maintain a mean arterial pressure (MAP) of 90 mmHg to 70 mmHg during tourniquet inflation. In addition, the inhalation of enflurane was adjusted to guarantee a hypnotic state based on entropy. The hemodynamic variables, inhaled concentration of enflurane, recovery time, and postoperative pain characteristics were measured and compared. RESULTS: Following tourniquet inflation, the MAP was increased and maintained in the target since 20 min after that in both group. Following tourniquet deflation the MAP was decreased significantly in both groups and more patients in group R required a vasopressor. Group R inhaled a lower enflurane concentration and showed more rapid recovery than group EN. There were no significant differences in the level of postoperative pain between the two groups. CONCLUSIONS: These results suggest that remifentanil is more likely to be associated with hypotension after tourniquet deflation and require more attention than nicardipine with esmolol.

The Effect of Minocycline on Allodynia Produced by Repeated Injection of Low pH Saline in Rats / 대한마취과학회지

BACKGROUND: Activation of glial cells (microglia and astroglia) has been observed in rat neuropathic pain models and they are known to play a role in inducing allodynia in these animals. Minocycline (MC), a tetracycline derivative antibiotics, displays selective inhibition of microglial activation. The author investigated antinociceptive effect of intrathecal administration of MC on muscular pain model induced by repetitive intramuscular injection of low pH saline. METHODS: pH 5 saline was injected into gastrocnemius muscle of rat. Second injection of pH 5 saline was done 3 days after first injection. To study preventive effect of MC, normal saline or MC 50microgram or 100microgram was administered intrathecally 15 min before each low pH saline injection. To evaluate the therapeutic effect, normal saline or MC 500microgram was administered intrathecally after pain model made. To quantify the mechanical allodynia, withdrawal threshold to mechanical stimuli was measured using von Frey filament. RESULTS: Preventive administration of MC 50microgram did not attenuate the mechanical allodynia, on the contrary MC 100microgram administration showed pain attenuation. Therapeutic administration of MC 500microgram did not show analgesic effect. CONCLUSIONS: Preventive intrathecal administration of MC 100microgram attenuated mechanical allodynia, but not in preventive MC 50microgram and therapeutic administration.

The Effect of Remifentanil, Alfentanil, and Fentanyl on the Hemodynamic Changes, Analgesia, and Sedation during Retrobulbar Block in Cataract Surgery / 대한마취과학회지

BACKGROUND: This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery. METHODS: Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3g/kg. Furthermore, group A received a 4.5g/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6g/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block. RESULTS: The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P 0.05). CONCLUSIONS: We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery.

The Effect of Cuff Pressure of Laryngeal Tube on Postoperative Sore Throat after General Anesthesia Using N2O / 대한마취과학회지

BACKGROUND: The cuff pressure (CP) of the laryngeal tube airway (LTA) increases during general anesthesia using nitrous oxide. However, there have been few studies on the relationship between CP and postoperative sore throat (POST). This study evaluated the efficacy of the CP on a POST on the recovery time and postoperative day. METHODS: Forty patients were divided into two groups, group M (n = 20) and group I (n = 20). In all patients, the CP was set to 65 cmH2O at the induction of anesthesia. In group M, the CP was maintained at 60-70 cmH2O during general anesthesia using N2O. However, in group I, the CP was allowed to increase. The CP was measured every 10 minutes during surgery in the two groups. The frequency and intensity (numerical rating scale of 0-100, NRS-101) of the sore throat was measured at recovery room (RR) and on postoperative day 1 (POD1). RESULTS: There was a significant increase in the CP in group I during general anesthesia and the CP was higher in group I than in group M (P < 0.05). The frequency of POST was higher in group I at RR (10% vs 70%) and POD1 (0% vs 35%) than in group M. In addition, the NRS-101 was higher in group I at RR and POD1 than in group M (P < 0.05). CONCLUSIONS: The CP of the LTA needs to be monitored and controlled during surgery in order to reduce POST.

Entropy Responses to Endotracheal Intubation during Anesthetic Induction Using Thiopental or Propofol and Succinylcholine / 대한마취과학회지

BACKGROUND: Thiopental and propofol are commonly used intravenous induction agents and entropy is a new method of assessing depth of anesthesia. In this study we evaluated the entropy responses to endotracheal intubation during anesthetic induction with thiopental or propofol. METHODS: Forty ASA class I and II adult female patients undergoing elective surgeries were enrolled into this randomized, prospective study. At 1 minute after fentanyl 2 microgram/kg, thiopental 5 mg/kg (group T) or propofol 2 mg/kg (group P) was administered for induction. And endotracheal intubation was performed following succiny choline 1 mg/kg. From pre-induction till post-intubation 10 minutes, the entropy and hemodynamic variables were measured and compared. RESULTS: The entropy following intubation increased significantly in both groups. But entropy changes in group T were greater than those in group P remained below 65. CONCLUSIONS: Our results using the entropy to monitor anesthetic depth during induction and intubation, suggest that thiopental 5 mg/kg is more likely to be associated with lighter planes of anesthesia and consequent risk of arousal reaction following endotracheal intubation than propofol 2 mg/kg.