Intravenous anesthesia

Abstract

Anesthesia and Pain Medicine. 2004 Mar. 8(1): 15-18
ⓒ Korean Society for Intravenous Anesthesia
  
 
 
The Effect of Spinal Block Level in the Requirements of Propofol for Conscious Sedation
Il Woo Shin, M.D., Seong Ho Ok, M.D., Hee Jin Kim, M.D., Ju Tae Sohn, M.D., Heon Keun Lee, M.D. and Young Kyun Chung, M.D.
Department of Anesthesiology and Pain Medicine, Gyeongsang National University Medical School, Jinju, Korea
 

Background: It has been reported that spinal anesthesia has a sedative effect and the degree of sedation is related to the level of spinal anesthesia. The level of spinal anesthesia seems to be an influencing factor in determining the hypnotic requirements for conscious sedation. Therefore, we conducted a prospective randomized study to investigate the effect of spinal anesthesia level on hypnotic requirements for conscious sedation.
Methods: Forty-five adult patients scheduled to undergo spinal anesthesia for anal surgery were randomly allocated to one of the two groups (Group 1: spinal anesthesia with 13 mg of 0.5% hyperbaric bupivacaine, Group 2: saddle block with 13 mg of 0.5% hyperbaric bupivacaine). Ten minutes after the block, target controlled infusion of propofol was started at a target concentration of 1mug/ml and we checked the lowest bispectral index (BIS) during 5 min observation period after effect site concentration of 1mug/ml was reached. Target controlled infusion of propofol was restarted at a target concentration of 1.5mug/ml and we checked the lowest BIS during 5 min observation period after effect site concentration of 1.5mug/ml was reached. We also checked the effect site concentration when the BIS reached 80 and 70 during observation period.
Results: The minimum BIS at 1mug/ml effect site concentration was 80.4 +/- 8.9, and 80.6 +/- 8.5 in group 1 and group 2 respectively. The minimum BIS at 1.5mug/ml effect site concentration was 64.2 +/- 13.4, 67.6 +/- 10.0 respectively. The effect site concentration of propofol when BIS 80 was checked at first was 1.1 +/- 0.3 mug/ml, 1.1 +/- 0.3mug/ml respectively. The effect site concentration of propofol when BIS 70 was checked at first was 1.3 +/- 0.3mug/ml, 1.4 +/- 0.3mug/ml respectively.
Conclusions: There was no significant difference in the requirements of propofol for conscious sedation between thoracic spinal anesthesia group and saddle block group.
 
Key words : Bispectral index, hypnosis, propofol, saddle block, spinal anesthesia
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