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The effect of ephedrine and phenylephrine on BIS values during propofol anaesthesia

Published online by Cambridge University Press:  01 March 2006

D. Takizawa ,
E. Takizawa ,
S. Miyoshi ,
F. Kawahara ,
N. Ito ,
J. Ishizeki ,
S. Koizuka  and
H. Hiraoka
D. Takizawa
Affiliation:
Gunma University, Graduate School of Medicine, Department of Anesthesiology, Maebashi, Japan Saitama Cardiovascular and Pulmonary Center, Department of Anesthesiology, Osato-gun, Saitama, Japan
E. Takizawa
Affiliation:
Gunma University, Graduate School of Medicine, Department of Anesthesiology, Maebashi, Japan
S. Miyoshi
Affiliation:
Saitama Cardiovascular and Pulmonary Center, Department of Anesthesiology, Osato-gun, Saitama, Japan
F. Kawahara
Affiliation:
Saitama Cardiovascular and Pulmonary Center, Department of Anesthesiology, Osato-gun, Saitama, Japan
N. Ito
Affiliation:
Gunma University, Graduate School of Medicine, Department of Anesthesiology, Maebashi, Japan
J. Ishizeki
Affiliation:
Gunma University, Graduate School of Medicine, Department of Anesthesiology, Maebashi, Japan
S. Koizuka
Affiliation:
Gunma University, Graduate School of Medicine, Department of Anesthesiology, Maebashi, Japan
H. Hiraoka
Affiliation:
Saitama Cardiovascular and Pulmonary Center, Department of Anesthesiology, Osato-gun, Saitama, Japan
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Extract

Summary

Backgrounds: The purpose of this study was to evaluate the effect of ephedrine and phenylephrine on propofol concentrations and bispectral index during propofol anesthesia. Methods: General anaesthesia was induced with propofol and was maintained with propofol (4 mg kg−1 h−1) and fentanyl. Vecuronium was used to facilitate the artificial ventilation of the lungs. Patients with systolic blood pressure > 90 mmHg were defined as the control group (n = 16). Patients who had to be treated for larger decreases in arterial blood pressure (systolic blood pressure <90 mmHg) were randomly assigned to receive ephedrine 0.1 mg kg−1 (n = 20) or phenylephrine 2 μg kg−1 (n = 20). Propofol concentrations were determined before (baseline) and at 3 and 10 min after the administration of ephedrine or phenylephrine. Bispectral index was monitored continuously. Cardiac output was determined using a pulmonary arterial catheter. Results: Ten minutes after drug injection, bispectral index in the ephedrine group increased significantly compared with the baseline and was significantly larger than that in the control or phenylephrine group. Eight patients in the ephedrine group had bispectral index >60, whereas no patient in the control or phenylephrine groups had bispectral index >60. There were no significant differences in propofol concentrations or cardiac output relative to baseline at 3 or 10 min after the administration of ephedrine or phenylephrine. Conclusions: Ephedrine increases bispectral index values without decreasing propofol concentrations during general anesthesia.

Keywords

ANAESTHETICS INTRAVENOUS, propofolSYMPATHOMIMETICS, ephedrine, phenylephrineELECTROENCEPHALOGRAPHY, bispectral indexPHARMACOKINETICS, drug interactionsANAESTHESIA, INTRAVENOUS, depth of anaesthesia
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 8 , August 2006 , pp. 654 - 657
Copyright
© 2006 European Society of Anaesthesiology

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References

Malec D, Langwinski R. Anticataleptic action of psychostimulating drugs and serotonin in brain. Acta Physiol Pol 1979; 30: 589–595.Google Scholar
Ishiyama T, Oguchi T, Iijima T, Matsukawa T, Kashimoto S, Kumazawa T. Ephedrine, but not phenylephrine, increases bispectral index values during combined general and epidural anesthesia. Anesth Analg 2003; 97: 780–784.Google Scholar
Takizawa D, Nishikawa K, Sato E et al. A dopamine infusion decreases propofol concentration during epidural blockade under general anesthesia. Can J Anaesth 2005; 52: 463–466.Google Scholar
Hiraoka H, Yamamoto K, Okano N, Morita T, Goto F, Horiuchi R. Changes in drug plasma concentrations of an extensively bound and highly extracted drug, propofol, in response to altered plasma binding. Clin Pharmacol Ther 2004; 75: 324–330.Google Scholar
Takizawa D, Hiraoka H, Goto F, Yamamoto K, Horiuchi R. Human kidneys play an important role in the elimination of propofol. Anesthesiology 2005; 102: 327–330.Google Scholar
Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology 1998; 88: 642–650.Google Scholar
Bowyer JF, Newport GD, Slikker Jr W, Gough B, Ferguson SA, Tor-Agbidye J. An evaluation of l-ephedrine neurotoxicity with respect to hyperthermia and caudate/ putamen microdialysate levels of ephedrine, dopamine, serotonin, and glutamate. Toxicol Sci 2000; 55: 133–142.Google Scholar
Domer FR, Wolf CL. Effects of lead on movement of albumin into brain. Res Commun Chem Pathol Pharmacol 1980; 29: 381–384.Google Scholar
Darracq L, Blanc G, Glowinski J, Tassin JP. Importance of the noradrenaline–dopamine coupling in the locomotor activating effects of D-amphetamine. J Neurosci 1998; 18: 2729–2739.Google Scholar
Guo TZ, Tinklenberg J, Oliker R, Maze M. Central alpha 1-adrenoceptor stimulation functionally antagonizes the hypnotic response to dexmedetomidine, an alpha 2-adrenoceptor agonist. Anesthesiology 1991; 75: 252–256.Google Scholar
Kurita T, Morita K, Kazama T, Sato S. Influence of cardiac output on plasma propofol concentrations during constant infusion in swine. Anesthesiology 2002; 96: 1498–1503.Google Scholar
Kazama T, Kurita T, Morita K, Nakata J, Sato S. Influence of hemorrhage on propofol pseudo-steady state concentration. Anesthesiology 2002; 97: 1156–1161.Google Scholar
Kurita T, Kazama T, Morita K et al. Influence of fluid infusion associated with high-volume blood loss on plasma propofol concentrations. Anesthesiology 2004; 100: 871–878.Google Scholar
Johnson KB, Egan TD, Kern SE, McJames SW, Cluff ML, Pace NL. Influence of hemorrhagic shock followed by crystalloid resuscitation on propofol: a pharmacokinetic and pharmacodynamic analysis. Anesthesiology 2004; 101: 647–659.Google Scholar
Takizawa D, Sato E, Kurosaki D, Hiraoka H, Horiuchi R, Goto F. Pharmacodynamics of propofol during hemorrhagic shock. Anesthesiology 2005; 102: 1068–1069.Google Scholar
Takizawa D, Sato E, Kurosaki D, Hiraoka H, Saito S, Goto F. The changes in unbound concentration of propofol during hemorrhage. Clin Pharmacol Ther 2005; 78: 93–95.Google Scholar