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Korean Journal of Anesthesiology 2008;54(4):373-377.
DOI: https://doi.org/10.4097/kjae.2008.54.4.373   
The Influence of a Muscle Relaxant on Bispectral Index during the Propofol Induction of Anesthesia.
Yun Chul Shin, Soon Im Kim, Si Young Ok, Sun Chong Kim
Department of Anesthesiology and Pain Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. soonnim@hosp.sch.ac.kr
Although neuromuscular blockade can influence the bispectral index (BIS) during anesthesia, there have been contradictory reports regarding its effects. The purpose of this study was to investigate whether a muscle relaxant affected the level of BIS during propofol anesthesia.
Forty-eight healthy patients undergoing elective surgery under general anesthesia were enrolled in this prospective, randomized, double-blind study. All patients received an effect-site targeted concentration of propofol via a TCI system that was titrated until loss of consciousness occurred. The patients then received either an injection of vecuronium (relaxant group, n = 24) or normal saline as a placebo (placebo group, n = 24) at 3 minutes after loss of consciousness. The BIS and electromyogram (EMG) activity were recorded from anesthetic induction to 4 minutes after injection of the vecuronium or placebo.
The BIS significantly decreased after injection in both groups (P < 0.05), however, the decrease in the BIS was larger in the relaxant group than in the placebo group (P < 0.05). The decrease of EMG activity was not significantly different between the two groups after administration of vecuronium or placebo.
During propofol induction of anesthesia, a muscle relaxant decreased BIS significantly without decreasing the EMG activity.
Key Words: bispectral index; electromyogram activity; muscle relaxant; propofol


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