BIS and Hemodynamic Change in Elderly Patients by Propofol Infusion for Induction. |
A Lee Chung, Guie Yong Lee |
Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. lgyanes@mm.ewha.ac.kr |
|
|
|
Abstract |
BACKGROUND Propofol is a good choice for elderly patents because it produces rapid onset and quick recovery with few side effects. Propofol produces dose-dependent cardiovascular depression. This effect is more pronounced in elderly patients during induction and can be minimized by a slow injection. The aim of this study was to determine the appropriate induction dose of propofol using a slower infusion rate for elderly patients to obtain desirable sedation and hypnotic conditions with minimal hemodynamic changes. METHODS Thirty-nine patients aged over 70 years were assigned to receive a propofol infusion of either 1.5 mg/kg (n = 21, Group 1) or 2.0 mg/kg (n = 18, group 2). The infusion rate was 20 mg/kg/hr. The systolic and diastolic pressure, heart rate, BIS and modified observers assessment of the alertness/sedation scale (OAA/S) were measured before the induction (baseline), after the propofol infusion, as well as immediately, 3 and 5 minutes after intubation. RESULTS The systolic pressure decreased significantly after the propofol infusion in both groups (group 1: 17%, group 2: 25%) but there were no significant differences between them.
The BIS values after the propofol infusion and intubation were 67.1 +/- 12.6 and 62.3 +/- 12.7 in group 1, 49.6 +/- 11.1 and 51.7 +/- 11.7 in group 2, respectively which showed significant differences between the groups. CONCLUSIONS When 2.0 mg/kg of propofol is administrated to elderly patients, a slower infusion rate is more appropriate for maintaining the desirable sedation and hypnotic conditions and cause no significant hemodynamic changes. |
Key Words:
bispectral index; elderly patient; hemodynamic change; propofol |
|