Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass.

Autor: Dos Santos Silva CG; Department of Anesthesiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil. Electronic address: cgss_phb@hotmail.com., Neto CN; Department of Anesthesiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil., Hirata MH; Department of Molecular Biology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil., Tardelli MA; Department of Anesthesiology, Federal University of Sao Paulo - Paulista Medical School, Sao Paulo, Brazil., Bastos GM; Department of Molecular Biology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil., França JID; Department of Statistical Analysis, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil., Cardoso TAAM; Department of Anesthesiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2021 Aug; Vol. 35 (8), pp. 2447-2453. Date of Electronic Publication: 2020 Dec 21.
DOI: 10.1053/j.jvca.2020.12.032
Abstrakt: Objectives: Minimum alveolar concentration (MAC) of volatile anesthetic agents to maintain bispectral index (BIS) below 50 in 50% of patients was defined as MACBIS50. The primary objective of this study was to determine the minimum alveolar concentration of sevoflurane as a single hypnotic agent to maintain BIS below 50 in patients during normothermic cardiopulmonary bypass.
Design: Prospective and observational study.
Setting: Dante Pazzanese Institute of Cardiology, Brazil.
Participants: Eighteen consecutive patients scheduled for elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under general anesthesia, American Society of Anesthesiologists physical status classes III and IV, between the ages of 40 and 70, were included in the study.
Methods: All patients underwent inhalation induction with facial mask using sevoflurane (Cristália) in 100% oxygen, pancuronium (Cristália) 0.1 mg/kg, and sufentanil (Cristália) 0.5 µg/kg intravenously (IV) administered. A single bolus dose of sufentanil, 1.0 µg/kg IV, was administered before surgical incision. MACBIS50 was calculated using the midpoint concentration of patients involving a crossover (BIS < or ≥50) according to Dixon's Up-and-Down method. The Up-and-Down sequence also was analyzed by probit test that enabled the authors to obtain the effective dose 50 (ED50) and effective dose 95 (ED95) of sevoflurane to maintain a BIS value <50, with a 95% confidence interval (95% CI) of the mean.
Results: A total of 15 patients were analyzed in this study. MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% (95% CI 0.47-1.16) in patients aged 40 to 70 undergoing CABG during normothermic CPB. The ED50 and ED95 of sevoflurane to maintain a BIS value <50 for the same context were 0.73% (95% CI 0.45-1.00) and 1.39 (95% CI 0.42-2.37) by means of probit analysis, respectively.
Conclusion: MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% in patients undergoing CABG during normothermic CPB.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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