Bispectral index in assessment of 3% and 4.5% desflurane in 50% N2O for caesarean section.

Ittichaikulthol, Wichai; Sriswasdi, Surirat; Prachanpanich, Naruemol; Watcharotayangul, Jittiya; Seangrung, Rattaphol; Sithamwilai, Wannipa

Bispectral index in assessment of 3% and 4.5% desflurane in 50% N2O for caesarean section.

Date

2007-08-12

Authors

Ittichaikulthol, Wichai

Sriswasdi, Surirat

Prachanpanich, Naruemol

Watcharotayangul, Jittiya

Seangrung, Rattaphol

Sithamwilai, Wannipa

Abstract

BACKGROUND: To prevent awareness and uterine atony among parturients during general anesthesia for caesarean section, volatile anesthetic agents have been limited to 0.5 MAC in 50% N2O. This technique appeared to be inadequate to produce BIS values less than 60 in isoflurane and sevoflurane. OBJECTIVE: To assess BIS value during general anesthesia with 3% and 4.5% desflurane in 50% N2O before delivery. MATERIAL AND METHOD: The parturients were blinded and randomized in opaque envelopes to one of the two study groups. Seventy-two elective caesarean section ASA I - II parturients were induced and intubated with thiopental 4 mg/kg, succinylcholine 1.5 mg/kg and were received either 3% or 4.5% desflurane in 50% N2O to maintain general anesthesia. Both groups received rocuronium 0.6 mg/kg for muscle relaxation. Morphine 0.1 mg/kg and midazolam 0.06 mg/kg were administered after delivery. RESULTS: There were no differences in demographic data in both groups. The incidences of patients with a satisfactory BIS score (< 60) in the 4.5% desflurane group was 81% that was significantly more than 42% in the 3% desflurane group (p < 0.000). Mean BIS values at neonatal delivery were 62 +/- 8 in the 3% desflurane group, versus 49 +/- 12 in the 4.5% desflurane group. Indices of maternal and neonatal outcome were similar between the two groups. CONCLUSION: General anesthesia for caesarean section with 4.5% desflurane in 50% N2O maintained BIS < 60 more significantly than 3% of desflurane in 50% N2O without maternal and neonatal adverse effects in healthy paturients.

Description

Chotmaihet Thangphaet.

Citation

Ittichaikulthol W, Sriswasdi S, Prachanpanich N, Watcharotayangul J, Seangrung R, Sithamwilai W. Bispectral index in assessment of 3% and 4.5% desflurane in 50% N2O for caesarean section. Journal of the Medical Association of Thailand. 2007 Aug; 90(8): 1546-50