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Korean Journal of Anesthesiology 2006;50(1):60-65.
DOI: https://doi.org/10.4097/kjae.2006.50.1.60   
Does Epidural Clonidine Decrease the Sevoflurane Concentration for Maintaining the BIS 50?
Young Jun Bahn, Hye Won Lee, Choon Hak Lim, Hae Ja Lim, Suk Min Yoon
Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Seoul, Korea. hyewonmd@unitel.co.kr
The aim of this study was to investigate the influence of epidural clonidine on the BIS, and its potential dose-sparing effect on the sevoflurane requirement for maintaining the BIS 50.
Forty ASA I or II patients aged 20 to 65, undergoing lower abdominal, gynecologic surgery under general anesthesia, were randomly allocated to either a 10 ml epidural normal saline injection group (n = 20) or a 10 ml epidural clonidine 3microgram/kg mixed with normal saline injection group (n = 20). They received 5 mg/kg thiopental sodium and 0.1 mg/kg vecuronium bromide for induction, with no premedication. After surgical incision, the sevoflurane concentration was controlled to maintain the BIS 50. Epidural saline or clonidine was then injected and end-tidal sevoflurane concentration to maintain the BIS 50, the heart rate (HR) and mean arterial pressure (MBP) were measured every 5 min over a 20 minute period.
The end-tidal sevoflurane concentration in the clonidine group decreased by 27.5% after the epidural clonidine injection (1.49 +/- 0.23 vol% vs. 1.08 +/- 0.27 vol%; P<0.05) compared with the saline group (1.36 +/- 0.18 vol% vs. 1.33 +/- 0.21 vol%; P>0.05). There were no changes in the heart rate and mean blood pressure in either group.
Epidural clonidine causes a significant decrease in the BIS, and lowers the end-tidal sevoflurane concentration required for maintaining the BIS 50.
Key Words: BIS; end-tidal sevoflurane concentration; epidural clonidine


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