| Bispectral Index Changes during Anesthesia Induction with Ketamine in Children. |
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Ji Young Lee, Se Ho Moon, Hyun Sik Chung |
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Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. jing75@naver.com |
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| Abstract |
BACKGROUND
The bispectral index (BIS) is a processed EEG information that has been validated as a means to measure the hypnotic effect of anesthetic drugs. The aim of this study was to evaluate the BIS changes during anesthesia induction with ketamine in children.
METHODS
Eighty-four ASA class I and II pediatric patients, aged 3-8 years, were enrolled in this study. In each patient the BIS value was recorded before anesthesia induction.
Without premedication, eighty-four patients received ketamine bolus, 1.0 mg/kg (Group 1, n = 28) or 1.5 mg/kg (Group 2, n = 28) or 2.0 mg/kg (Group 3, n = 28). When unresponsiveness to verbal commands (UVC) and loss of eyelash reflex (LER) were ascertained, intubation was performed after administration of succinylcholine 1.5 mg/kg and anesthesia was maintained with 2.0% enflurane and 50% N2O-50% O2.
RESULTS
Ketamine bolus induced UVC and LER at which the BIS values were, 92.5+/-5.6 and 93.9+/-3.0 for Group 1, 92.5+/-6.3 and 92.6+/-4.4 for Group 2, and 93.0+/-4.3 and 91.0+/-4.1 for Group 3. BIS from UVC and LER to three minutes after ketamine bolus remained above 90 for Group 1 and 2, whereas lower than Group 1 for Group 3 (P<0.05).
However, the BIS for Group 3 showed above 85 as patient entered into clinical anesthetic state.
CONCLUSIONS
Our study showed that there is a lack of correlation between the BIS and the anesthetic state induced by ketamine in children aged 3-8 years. Monitoring the depth of ketamine anesthesia remains difficulty. |
| Key Words:
anesthesia; bispectral index; ketamine; pediatric |
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