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Korean Journal of Anesthesiology 2000;38(2):251-257.
DOI: https://doi.org/10.4097/kjae.2000.38.2.251   
The Bispectral Index and Modified Observer's Assessment of Alertness/Sedation Scale Comparable to Effect Site Concentration of Propofol in Koreans.
Ho Yeong Kil, Seong Ik Lee, Seung Joon Lee, Sung Woo Lee, Dong Ho Lee
1Department of Anesthesiology, College of Medicine, Hallym University, Seoul, Korea.
2Department of Anesthesiology, College of Medicine, Han Yang University, Seoul, Korea.
Propofol has been frequently used for sedation or hypnosis in anesthesia and is relatively accurate in the dose-response relationship for hypnosis. The aim of this study was to define the bispectral index and modified observer's assessment of alertness/sedation (OAA/S) scale at various effect site concentrations (Ce) of propofol in Koreans.
Fifty premedicated (atropine 0.5 mg, I.M.) adult patients (ASA class I or II, 20 55 yrs) scheduled for elective orthopedic surgery were studied. Propofol was infused until 2 min after the target concentration equilibrated with the effect site concentration (Ce) of propofol using Master TCI. The target concentration of propofol was stepwise increased at intervals of 0.5 microgram/ml until BIS reached 40, BIS and OAA/S at each Ce of propofol were checked. If SpO2 decreased below 90%, oxygen (4 l/min) was given via nasal cannula.
BIS was 97.9 +/- 0.2 and OAA/S 5 +/- 0.0 at a Ce of propofol of 0 microgram/ml; the Ce of propofol was 3.5 microgram/ml and OAA/S 0.1 +/- 0.3 at a BIS of 41.1 +/- 2.5. Also, systolic BP at a Ce of propofol above 1.0 microgram/ml and diasolic BP at a Ce of propofol above 1.5 microgram/ml significantly decreased compared to the control (P < 0.05). However, heart rate did not show any difference compared to the control value. Above a 1.0 microgram/ml Ce, fifty-eight percent of patients showed SpO2 < 90%, but there was no incidence of apnea. There were significant correlations between Ce of propofol, BIS and OAA/S.
BIS showed a significant correlation with Ce of propofol (Spearman's r = 1.0) (P < 0.0001). The Ce of propofol was above 3.0 microgram/ml for BIS50.


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