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The effect of pyridostigmine on bispectral index during recovery from sevoflurane anesthesia

Title
The effect of pyridostigmine on bispectral index during recovery from sevoflurane anesthesia
Authors
Jeong S.-J.Han J.I.Baik H.-J.Lee H.Lee G.Y.Kim J.-H.
Ewha Authors
이귀용김종학한종인백희정이희승
SCOPUS Author ID
이귀용scopus; 김종학scopus; 한종인scopus; 백희정scopus; 이희승scopus
Issue Date
2011
Journal Title
Korean Journal of Anesthesiology
ISSN
2005-6419JCR Link
Citation
vol. 61, no. 6, pp. 460 - 464
Indexed
SCOPUS; KCI scopus
Abstract
Background: There have been some conflicting reports showing that muscle relaxants and anticholinesterases affect the level of the bispectral index (BIS). The purpose of this study was to investigate whether pyridostigmine affects the level of the BIS during recovery from sevoflurane anesthesia. Methods: Fifty-two adult patients scheduled for laparoscopic cholecystectomy and laparoscopic appendectomy. Anesthesia was induced with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. The lung was mechanically ventilated with 1-3 vol% sevoflurane, 50% oxygen and 50% nitrous oxide. After a specimen was removed, the sevoflurane concentration was maintained at 1.5 vol%. When skin closure began, sevoflurane was stopped; however, 50% oxygen and 50% nitrous oxide were maintained. The patients then received either (1) a group that received an injection of glycopyrrolate 0.04 mg/kg and pyridostigmine 0.2 mg/kg (reverse (R) group, n = 26) or (2) a group that received normal saline (control (C) group, n = 26). Group assignment was random. Pyridostigmine, a reversible cholinesterase inhibitor, is a parasympathomimetic. End-tidal sevoflurane concentration, train of four (TOF) ratio, bispectral index (BIS), blood pressure and heart rate were measured from the end of the operation to 15 min after inject of pyridostigmine or placebo. Results: There were no significant between group differences in the time dependent decrease in end-tidal sevoflurane concentration (P = 0.0642). There were significant differences between the two groups for the time course for increases in the TOF value (P < 0.0001). There were significant differences between the two groups for the time course for increases in the BIS value (P = 0.0107). There were no significant differences in the mean BIS value up to 10 minutes after administering drug, but 15 minutes after administrating the reverse drug or the control drug, the BIS value showed significantly different BIS values: 68.2 ± 6.2 (Group R) and 63.2 ± 6.2 (Group C) (P = 0.0058). Conclusions: The finding that pyridostigmine increases TOF and BIS suggests that pyridostigmine may enhance recovery during recovery from sevoflurane anesthesia. © the Korean Society of Anesthesiologists, 2011.
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의학전문대학원 > 의학과 > Journal papers
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