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A single dose of esmolol blunts the increase in bispectral index to tracheal intubation during sevoflurane but not desflurane anesthesia

Authors
 Seung Ho Choi  ;  Chang Seok Kim  ;  Jong Hoon Kim  ;  Bum Su Kim  ;  Eun Mi Kim  ;  Kyeong Tae Min 
Citation
 JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY, Vol.21(3) : 214-217, 2009 
Journal Title
 JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY 
ISSN
 0898-4921 
Issue Date
2009
MeSH
Adolescent ; Adrenergic beta-Antagonists/therapeutic use* ; Adult ; Aged ; Anesthesia, Inhalation* ; Anesthetics, Inhalation* ; Blood Pressure/drug effects ; Double-Blind Method ; Electroencephalography/drug effects* ; Female ; Heart Rate/drug effects ; Humans ; Intubation, Intratracheal* ; Isoflurane/analogs & derivatives* ; Male ; Methyl Ethers* ; Middle Aged ; Propanolamines/therapeutic use* ; Young Adult
Keywords
BIS ; desflurane ; esmolol ; intubation ; sevoflurane
Abstract
Activation of the peripheral nerve system by endotracheal intubation is accompanied by an increase in bispectral index (BIS). Esmolol produces a dose-dependent attenuation of the adrenergic response to endotracheal intubation. Desflurane increases sympathetic nerve activity and plasma norepinephrine relative to sevoflurane. The authors hypothesized that esmolol might blunt the BIS response to endotracheal intubation more during sevoflurane anesthesia than desflurane anesthesia. In this double blind, randomized study, after the induction of anesthesia, patients were mask-ventilated with either sevoflurane or desflurane (end-tidal 1 minimum alveolar concentration) and received normal saline or esmolol (0.5 mg/kg) 1 minute before intubation (sevoflurane-control, sevoflurane-esmolol, desflurane-control, and desflurane-esmolol groups, n=20/group). BIS, mean arterial pressure, and heart rate were measured before the induction of anesthesia (awake), before esmolol injection (time point -1), immediately before intubation (time point 0), and every minute for 5 minutes after tracheal intubation (time point 1 to 5). Compared with preintubation, esmolol attenuated the increase in BIS at 1 minute after intubation during sevoflurane anesthesia (5.1% for esmolol and 31.7% for control) but not during desflurane anesthesia (28.6% for esmolol and 30.8% for control). Mean arterial pressure and heart rate increased after intubation in all groups but the changes were greater in the control groups than the esmolol groups. In conclusion, a single dose of esmolol blunted the increase in BIS to tracheal intubation during sevoflurane but not desflurane anesthesia.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00008506-200907000-00005&LSLINK=80&D=ovft
DOI
10.1097/ANA.0b013e3181a41e69
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Hoon(김종훈)
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104003
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