The Change of Bispectral Index in Endotracheal Intubation with Propofol and Remifentanil without Muscle Relaxant

ABSTRACT

BACKGROUND: There have been conflicting reports about the effect of muscle relaxant to bispectral index during propofol anesthesia. The purpose of this study was to investigate the change of bispectral index (BIS) in endotracheal intubation with propofol and remifentanil without muscle relaxant and to compare with those in endotracheal intubation with muscle relaxant. METHODS: Forty-eight ASA physical status I or II patients were randomly allocated to 2 groups. Each patient were anesthetized with propofol at target effect site concentration of 4.0microg/ml with remifentanil 3.0microg/kg. Saline was injected in Group S and rocuronium 0.6 mg/kg was injected in Group R. Intubation was attempted, and the BIS, intubating condition, mean arterial pressure and heart rate were observed up to 5 minutes after intubation. RESULTS: BIS was elevated after intubation in Group S. BIS after intubation in group S were significantly higher than group R. BIS after injection of rocuronium in group R was significantly decreased. There were no significant differences in hemodynamic datas in two groups. Intubation condition was acceptable in all patients. CONCLUSIONS: The BIS in endotracheal intubation with propofol and remifentanil without muscle relaxantI can be higher than in endotracheal intubation with muscle relaxant.