The performance of Bispectral Index in children during equi-MAC halothane vs. sevoflurane anaesthesia

T. Taivainen (Corresponding Author), J. Klockars, A. Hiller, J. Wennervirta, Mark van Gils, P. Suominen

Research output: Contribution to journalArticleScientificpeer-review

2 Citations (Scopus)

Abstract

Background and objective: The reliability of the Bispectral Index for evaluating and monitoring the depth of general anaesthesia in children is not as great as for that in adults. Therefore we analysed Bispectral Index performance in children by comparing changes in Bispectral Index values during a standardized and equipotent anaesthetic regimen using either halothane or sevoflurane for the induction and maintenance of general anaesthesia. Special interest was focussed on excitation during induction, and whether it was associated with simultaneous changes in Bispectral Index scores.
Methods: Twenty children (3-15 yr, ASA I-II) scheduled for general surgery were randomly allocated to either halothane (10 patients) or sevoflurane group (10 patients). Anaesthesia was induced by 3% halothane or 7% sevoflurane, either agent administered with 50% N2O in oxygen for 5 min, the period from the beginning of induction until intubation. Thereafter, anaesthesia was maintained by the respective volatile agent at 1 MAC (minimum alveolar concentration; in addition to 70% N2O in oxygen) and supplemented with remifentanil infusion adjusted to maintain the heart rate and mean arterial pressure to within 20% of the baseline values. Excitation at induction was defined as involuntary muscular movements.
Results: Sevoflurane induction produced a more rapid depression in Bispectral Index than halothane, the mean difference being greatest (47 Bispectral Index score) at 105 s. Excitation occurred in three patients during sevoflurane induction, which coincided with increases in Bispectral Index values in two of the three patients. During the maintenance phase at 1 MAC, the Bispectral Index (mean ± SD) was 57±7 for halothane and 47±9 for sevoflurane (P < 0.05). The remifentanil doses did not differ between both groups.
Conclusion: In children, halothane anaesthesia was associated with higher Bispectral Index values than sevoflurane when administered at 1 MAC. Large individual variation in Bispectral Index occurred within both groups. Due to these limitations, one should be cautious when interpreting paediatric Bispectral Index data.
Original languageEnglish
Pages (from-to)933-939
Number of pages7
JournalEuropean Journal of Anaesthesiology
Volume25
Issue number11
DOIs
Publication statusPublished - 2008
MoE publication typeA1 Journal article-refereed

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Halothane
Anesthesia
General Anesthesia
Maintenance
Oxygen
Dyskinesias
sevoflurane
Intubation
Anesthetics
Arterial Pressure
Heart Rate
Pediatrics

Keywords

  • anaesthesia inhalational
  • child
  • child preschool
  • halothane
  • sevoflurane
  • Bispectral index

Cite this

Taivainen, T. ; Klockars, J. ; Hiller, A. ; Wennervirta, J. ; van Gils, Mark ; Suominen, P. / The performance of Bispectral Index in children during equi-MAC halothane vs. sevoflurane anaesthesia. In: European Journal of Anaesthesiology. 2008 ; Vol. 25, No. 11. pp. 933-939.
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title = "The performance of Bispectral Index in children during equi-MAC halothane vs. sevoflurane anaesthesia",
abstract = "Background and objective: The reliability of the Bispectral Index for evaluating and monitoring the depth of general anaesthesia in children is not as great as for that in adults. Therefore we analysed Bispectral Index performance in children by comparing changes in Bispectral Index values during a standardized and equipotent anaesthetic regimen using either halothane or sevoflurane for the induction and maintenance of general anaesthesia. Special interest was focussed on excitation during induction, and whether it was associated with simultaneous changes in Bispectral Index scores.Methods: Twenty children (3-15 yr, ASA I-II) scheduled for general surgery were randomly allocated to either halothane (10 patients) or sevoflurane group (10 patients). Anaesthesia was induced by 3{\%} halothane or 7{\%} sevoflurane, either agent administered with 50{\%} N2O in oxygen for 5 min, the period from the beginning of induction until intubation. Thereafter, anaesthesia was maintained by the respective volatile agent at 1 MAC (minimum alveolar concentration; in addition to 70{\%} N2O in oxygen) and supplemented with remifentanil infusion adjusted to maintain the heart rate and mean arterial pressure to within 20{\%} of the baseline values. Excitation at induction was defined as involuntary muscular movements.Results: Sevoflurane induction produced a more rapid depression in Bispectral Index than halothane, the mean difference being greatest (47 Bispectral Index score) at 105 s. Excitation occurred in three patients during sevoflurane induction, which coincided with increases in Bispectral Index values in two of the three patients. During the maintenance phase at 1 MAC, the Bispectral Index (mean ± SD) was 57±7 for halothane and 47±9 for sevoflurane (P < 0.05). The remifentanil doses did not differ between both groups.Conclusion: In children, halothane anaesthesia was associated with higher Bispectral Index values than sevoflurane when administered at 1 MAC. Large individual variation in Bispectral Index occurred within both groups. Due to these limitations, one should be cautious when interpreting paediatric Bispectral Index data.",
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The performance of Bispectral Index in children during equi-MAC halothane vs. sevoflurane anaesthesia. / Taivainen, T. (Corresponding Author); Klockars, J.; Hiller, A.; Wennervirta, J.; van Gils, Mark; Suominen, P.

In: European Journal of Anaesthesiology, Vol. 25, No. 11, 2008, p. 933-939.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The performance of Bispectral Index in children during equi-MAC halothane vs. sevoflurane anaesthesia

AU - Taivainen, T.

AU - Klockars, J.

AU - Hiller, A.

AU - Wennervirta, J.

AU - van Gils, Mark

AU - Suominen, P.

N1 - Project code: 31868

PY - 2008

Y1 - 2008

N2 - Background and objective: The reliability of the Bispectral Index for evaluating and monitoring the depth of general anaesthesia in children is not as great as for that in adults. Therefore we analysed Bispectral Index performance in children by comparing changes in Bispectral Index values during a standardized and equipotent anaesthetic regimen using either halothane or sevoflurane for the induction and maintenance of general anaesthesia. Special interest was focussed on excitation during induction, and whether it was associated with simultaneous changes in Bispectral Index scores.Methods: Twenty children (3-15 yr, ASA I-II) scheduled for general surgery were randomly allocated to either halothane (10 patients) or sevoflurane group (10 patients). Anaesthesia was induced by 3% halothane or 7% sevoflurane, either agent administered with 50% N2O in oxygen for 5 min, the period from the beginning of induction until intubation. Thereafter, anaesthesia was maintained by the respective volatile agent at 1 MAC (minimum alveolar concentration; in addition to 70% N2O in oxygen) and supplemented with remifentanil infusion adjusted to maintain the heart rate and mean arterial pressure to within 20% of the baseline values. Excitation at induction was defined as involuntary muscular movements.Results: Sevoflurane induction produced a more rapid depression in Bispectral Index than halothane, the mean difference being greatest (47 Bispectral Index score) at 105 s. Excitation occurred in three patients during sevoflurane induction, which coincided with increases in Bispectral Index values in two of the three patients. During the maintenance phase at 1 MAC, the Bispectral Index (mean ± SD) was 57±7 for halothane and 47±9 for sevoflurane (P < 0.05). The remifentanil doses did not differ between both groups.Conclusion: In children, halothane anaesthesia was associated with higher Bispectral Index values than sevoflurane when administered at 1 MAC. Large individual variation in Bispectral Index occurred within both groups. Due to these limitations, one should be cautious when interpreting paediatric Bispectral Index data.

AB - Background and objective: The reliability of the Bispectral Index for evaluating and monitoring the depth of general anaesthesia in children is not as great as for that in adults. Therefore we analysed Bispectral Index performance in children by comparing changes in Bispectral Index values during a standardized and equipotent anaesthetic regimen using either halothane or sevoflurane for the induction and maintenance of general anaesthesia. Special interest was focussed on excitation during induction, and whether it was associated with simultaneous changes in Bispectral Index scores.Methods: Twenty children (3-15 yr, ASA I-II) scheduled for general surgery were randomly allocated to either halothane (10 patients) or sevoflurane group (10 patients). Anaesthesia was induced by 3% halothane or 7% sevoflurane, either agent administered with 50% N2O in oxygen for 5 min, the period from the beginning of induction until intubation. Thereafter, anaesthesia was maintained by the respective volatile agent at 1 MAC (minimum alveolar concentration; in addition to 70% N2O in oxygen) and supplemented with remifentanil infusion adjusted to maintain the heart rate and mean arterial pressure to within 20% of the baseline values. Excitation at induction was defined as involuntary muscular movements.Results: Sevoflurane induction produced a more rapid depression in Bispectral Index than halothane, the mean difference being greatest (47 Bispectral Index score) at 105 s. Excitation occurred in three patients during sevoflurane induction, which coincided with increases in Bispectral Index values in two of the three patients. During the maintenance phase at 1 MAC, the Bispectral Index (mean ± SD) was 57±7 for halothane and 47±9 for sevoflurane (P < 0.05). The remifentanil doses did not differ between both groups.Conclusion: In children, halothane anaesthesia was associated with higher Bispectral Index values than sevoflurane when administered at 1 MAC. Large individual variation in Bispectral Index occurred within both groups. Due to these limitations, one should be cautious when interpreting paediatric Bispectral Index data.

KW - anaesthesia inhalational

KW - child

KW - child preschool

KW - halothane

KW - sevoflurane

KW - Bispectral index

U2 - 10.1017/S0265021508004845

DO - 10.1017/S0265021508004845

M3 - Article

VL - 25

SP - 933

EP - 939

JO - European Journal of Anaesthesiology

JF - European Journal of Anaesthesiology

SN - 0265-0215

IS - 11

ER -