J Clin Monit Comput - Reversal of neuromuscular blockade by sugammadex does not affect EEG derived indices of depth of anesthesia.

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Resumo

JECTIVE: According to previous studies neuromuscular blockade may affect the depth of anesthesia. One theory states that neuromuscular blockade prevents disturbing EMG signals, arousing from the muscles of the forehead, from falsely elevating bispectral index (BIS)-levels. According to the afferentation theory signals generated in muscle stretch receptors, accessing the brain through afferent nerve pathways, induce arousal. By blocking these signals neuromuscular blockade would increase depth of anesthesia. Arousal has previously been associated with neostigmine reversal. This study investigates the possible effect of sugammadex on the level of anesthesia as defined by BIS and spectral entropy levels.METHODS: Thirty elective patients were enrolled. All patients received propofol and remifentanil by target controlled infusion and an intermediate level neuromuscular blockade induced and maintained by bolus doses of rocuronium. Depth of anesthesia was monitored by BIS and spectral entropy. The patients were given 2?mg/kg sugammadex 5?min after finishing of surgery. Propofol and remifentanil infusions were kept unchanged for another 10?min while BIS and entropy values were recorded.RESULTS: Mean BIS and Entropy? values remained unchanged after reversal of the rocuronium block. The mean averaged BIS, state entropy and response entropy values were 31.7 ? 9.9, 35.3 ? 12.9 and 36.8 ? 13.3 before and 32.0 ? 11.9, 36.3 ? 15.9 and 38.4 ? 18.0 after sugammadex administration, respectively.CONCLUSIONS: Sugammadex does not affect level of anesthesia as determined by BIS or entropy levels.

Resumo Limpo

jectiv accord previous studi neuromuscular blockad may affect depth anesthesia one theori state neuromuscular blockad prevent disturb emg signal arous muscl forehead fals elev bispectr index bislevel accord afferent theori signal generat muscl stretch receptor access brain affer nerv pathway induc arous block signal neuromuscular blockad increas depth anesthesia arous previous associ neostigmin revers studi investig possibl effect sugammadex level anesthesia defin bis spectral entropi levelsmethod thirti elect patient enrol patient receiv propofol remifentanil target control infus intermedi level neuromuscular blockad induc maintain bolus dose rocuronium depth anesthesia monitor bis spectral entropi patient given mgkg sugammadex min finish surgeri propofol remifentanil infus kept unchang anoth min bis entropi valu recordedresult mean bis entropi valu remain unchang revers rocuronium block mean averag bis state entropi respons entropi valu sugammadex administr respectivelyconclus sugammadex affect level anesthesia determin bis entropi level

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