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• W2017268346 abstract "S53 INTRODUCTION: The lowest concentration of hypnotic drugs is often desired to 1) decrease side effects; 2) shorten awakening time; 3) decrease costs. Worry about awareness, especially when narcotics and muscle relaxants are used, inhibits lowering doses. We hypothesized that use of the BIS monitor would allow the benefits with still avoiding awareness. METHODS: After IRB approval and written informed consent, 44 patients scheduled for day-case surgery expected to last less than 1 hour were enrolled in a double-blind, four-arm randomized study. Patients received either etomidate or propofol in two subgroups. Anesthesia was induced with remifentanil (1 [micro sign]g/kg) and either etomidate (0.3 mg/kg) or propofol (2 mg/kg). Anesthesia was maintained with remifentanil (0.25 mg/kg/h) and either etomidate (1 mg/kg/h) or propofol (8 mg/kg/h) (subgroup 1). Doses of etomidate and propofol were reduced in subgroup 2 according to the EEG criterion 50% Bispectral Index (BIS). Recovery variables were determined. Statistical significance was defined as P <or=to 0.05. RESULTS: Demographic data of the 43 evaluable patients (etomidate group: 22; propofol group: 21) did not differ significantly. Anesthesia of each group in subgroup 1 was maintained with a high dose of etomidate (0.85 mg/kg/h) or propofol (6.9 mg/kg/h), respectively. In this high dose subgroup with a total dose of 75.4 mg, etomidate patients were extubated 11.3 min after the end of infusion (duration: 49 min) whereas propofol patients were extubated 6.7 min (P<0.05) after the end of infusion (duration: 47 min; total dose: 546 mg) (all data mean); BIS during the infusion did not differ. In patients of subgroup 2, the infusion rate was adjusted to 0.6 mg/kg/h of etomidate and 5.4 mg/kg/h of propofol). Despite of this, in the etomidate group BIS was significantly lower during the maintenance period (Figure 1). After a duration of infusion of 54 min with a total dose of 61.8 mg etomidate or 59.8 min and 511 mg propofol, respectively, patients were extubated 6.6 min or 8.7 min (P<0.05) (all means), respectively, after end of infusion. Blood circulation was more stable in the etomidate group. No patient vomited postoperatively. Well-being of patients was comparable between groups and all patients were discharged from the unit 2 hours after the end of anesthesia.Figure 1DISCUSSION: Monitoring of depth of anesthesia by BIS allows significant reduction of the infusion rate of the hypnotic (etomidate: 30%; propofol: 22%). BIS is, therefore, a useful parameter for safe, low-dose maintenance of anesthesia." @default.
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• W2017268346 date "1999-02-01" @default.
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• W2017268346 title "TIVA WITH ETOMIDATE OR PROPOFOL IN DAY-CASE SURGERY" @default.
• W2017268346 doi "https://doi.org/10.1097/00000539-199902001-00053" @default.
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