The Effect of the Spinal Block Level on the Requirements of Propofol for Sedation. |
Il Woo Shin, Ji Eun Go, Kyeong Eon Park, Ju Tae Sohn, Young Kyun Chung, Heon Keun Lee |
1Department of Anesthesiology and Pain Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea. ane1959@hanmail.net 2Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea. |
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Abstract |
BACKGROUND It has been reported that spinal anesthesia has a sedative effect and so this decreases the hypnotic requirement of intravenous anesthetic. Therefore, we have conducted a prospective randomized study to investigate the effect of the spinal anesthesia level on the hypnotic requirements for conscious sedation. METHODS Forty adult patients were scheduled to undergo spinal anesthesia, and they were randomly allocated to one of the two groups. After subarachnoid injection of 0.5% hyperbaric bupivacaine 16 mg, the patients in group 1 and group 2 were maintained in a reversed Trendelenburg position and a Trendelenburg position, respectively. After fifteen minutes, the target controlled infusion of propofol was started for achieving a target concentration of 1 microgram/ml, and the mean BIS for 1 min was checked after an effect site concentration (Ce) of 1 microgram/ml was reached. The target controlled infusion of propofol was restarted at a target concentration (Tc) of 1.5 microgram/ml, and the mean BIS for 1 min was checked after the Ce level of 1.5 microgram/ml was reached. RESULTS The mean BIS at 1 microgram/ml Ce was 90.0 +/- 8.5 and 77.8 +/- 10.3 in group 1 and group 2, respectively. The mean BIS at 1.5 g/ml Ce was 73.6 +/- 19.4 and 60.0 +/- 13.1, respectively. CONCLUSIONS There was a significant difference in the requirements of propofol for conscious sedation between the below T12 block group and the above T4 block group. |
Key Words:
bispectral index; hypnosis; propofol; spinal anaesthesia |
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