Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population

Akwasi Antwi-Kusi; Bright Ighodaro Obasuyi

doi:doi:10.11648/j.ja.20170501.11

| Peer-Reviewed

Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population

Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi

Published in Journal of Anesthesiology (Volume 5, Issue 1)

Received: 5 December 2016 Accepted: 5 January 2017 Published: 6 February 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

General anaesthesia is a balance between the amount of anaesthetic drug(s) administered and the state of arousal of the patient. Different patients may need variable doses of anaesthetics to reach and maintain a surgical level of anaesthesia. Even though lack of autonomic response suggests sufficient analgesia during surgery, there is no such clear clinical sign for the assessment of the depth and sedation of anaesthesia especially in a paralysed patient. Bispectra index (BIS) monitors the depth of anaesthesia and helps the anaesthetist to deliver the minimal dose of anaesthetic agent required to achieve an adequate hypnotic state. In this study conducted at the Komfo Anokye Teaching Hospital, patients undergoing general anaesthesia received intravenous propofol and remifentanil under BIS monitor as the sole anaeshetic. At the end of the surgery the total amount of propofol and remifentanil consumed and the time it took for the patients to open the eye and respond to verbal commands were noted. Propofol consumption was calculated to beat an averagerate of 5.44mg/kg/h and remifentanil at 13.68ug/kg/h to maintain a surgical level of anaesthesia. The mean time from stopping the anaesthetic agents until the patients opened the eyes and responded to verbal commands were 2.20 minutes and 2.70 minutes respectively. The study found that Propofol and remifentanil infusions at a rate of 5.44mg/kg/h and 13.68ug/kg/h respectively, under BIS monitor, effectively controls intraoperative responses and allow for rapid emergence from anaesthesia in a Ghanaian population.

Published in	Journal of Anesthesiology (Volume 5, Issue 1)
DOI	10.11648/j.ja.20170501.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Total Intravenous Anaesthesia, Bispectra Index, Remifentanil, Propofol

References

[1]	Kalow W, Tang BK, Endrenyi L. Hypothesis: comparisons of inter- and intra-individual variations can substitute for twin studies in drug research. Pharmacogenetics 1998; 8:283–289.
[2]	U. S. Food and Drug Administration, U.S. Dept. of Health and Human Services. International Conference on Harmonisation: guidance on ethnic factors in the acceptability of foreign clinical data availability. Federal Register 1998; 63:31790–31796.
[3]	H. L Kaul and Neerja Bharti, Monitoring depth of anaesthesia. Indian J Anaesth 2010; 46: 323-332.
[4]	Rosow C, Manberg PJ, Bispectra index monitoring. Anesthesiol Clin North America2001; 19: 947-966.
[5]	Gan TJ, Glass PS, Windsor A, et al. Bispectra index monitoring allows faster emergence and improved recovery from propofol, alfentanil and nitrous oxide. Anesthesiology 1997; 87: 808-815.
[6]	Rampil I J. A primer for EEG signals processing in anaesthesia. Anesthesiology 1998; 89: 980-1002.
[7]	Ortolani O, Conti A, Sall B. et al The recovery of Senegalese African Blacks from Intravenous Anaesthesia with Propofol and Remifentanil is slower than that of Caucasians. Anesth Analg 2001;93:1222-1226.
[8]	Houghton IT, ChanK,Wong YC, et al. Pethidine pharmacokinetics after intramuscular dose: a comparison in Caucasian, Chinese and Nepalese patients. Clin Pharmacol 1992; 14: 451-458.
[9]	Chan A, Nickoll E, Thorton C, et al. Spontaneous movement after injection of propofol. Anesthesia 1996; 51: 663-666.
[10]	Short TG, Aun CST, Tan H. Prospective evaluation of pharmacokinetic model-controlled infusion of propofol in paediatric patients. Br J Anaesthesia 1994; 72: 302-330.
[11]	Critchley JA, Nimmo GR, Gregson CA, et al. Intersubject and ethnic differences in paracetamol metabolism. Br J Clin Pharmacol 1986; 22: 649-657.
[12]	Iron A, Groppi A, Fleury B, et al. Polymorphism of class I alcohol dehydrogenase in French, Vietnamese and Niger populations: genotyping by PCR amplification and RFLP analysis of dried blood spot. Ann Genet 1992; 35: 152-156.
[13]	Shepherd J, Jones J, et al Clinical effectiveness and cost-effectiveness of depth of anaesthesia monitoring (E-Entropy, Bispectra index and Narcotrend): a systematic review and economic evaluation. Health Technol Assess 2013; 34: 1–264.
[14]	Gan TJ, Glass PJ, Windsor et al Bispectra Index monitoring allows faster emergence and improved recovery from propofol, alfentanil and nitrous oxide anaesthesia. Anesthesiology 1997; 87: 808-815.
[15]	Lindi NA, Arnett DK, Acton RT. Influence of CYP2C9 and VKORC11173C/T genotype on the risk of haemorrhagic complication in African-American and European-American patients on warfarin. Clin pharmacol. Ther. 2008; 83: 312-321.
[16]	Cordell HJ, Clayton DG. Genetic association studies Lancet 2005; 366: 1121-31.

Cite This Article

Plain Text BibTeX RIS

APA Style

Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi. (2017). Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. International Journal of Anesthesia and Clinical Medicine, 5(1), 1-4. https://doi.org/10.11648/j.ja.20170501.11

Copy | Download

ACS Style

Akwasi Antwi-Kusi; Bright Ighodaro Obasuyi. Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. Int. J. Anesth. Clin. Med. 2017, 5(1), 1-4. doi: 10.11648/j.ja.20170501.11

Copy | Download

AMA Style

Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi. Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. Int J Anesth Clin Med. 2017;5(1):1-4. doi: 10.11648/j.ja.20170501.11

Copy | Download

@article{10.11648/j.ja.20170501.11,
  author = {Akwasi Antwi-Kusi and Bright Ighodaro Obasuyi},
  title = {Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {5},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ja.20170501.11},
  url = {https://doi.org/10.11648/j.ja.20170501.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20170501.11},
  abstract = {General anaesthesia is a balance between the amount of anaesthetic drug(s) administered and the state of arousal of the patient. Different patients may need variable doses of anaesthetics to reach and maintain a surgical level of anaesthesia. Even though lack of autonomic response suggests sufficient analgesia during surgery, there is no such clear clinical sign for the assessment of the depth and sedation of anaesthesia especially in a paralysed patient. Bispectra index (BIS) monitors the depth of anaesthesia and helps the anaesthetist to deliver the minimal dose of anaesthetic agent required to achieve an adequate hypnotic state. In this study conducted at the Komfo Anokye Teaching Hospital, patients undergoing general anaesthesia received intravenous propofol and remifentanil under BIS monitor as the sole anaeshetic. At the end of the surgery the total amount of propofol and remifentanil consumed and the time it took for the patients to open the eye and respond to verbal commands were noted. Propofol consumption was calculated to beat an averagerate of 5.44mg/kg/h and remifentanil at 13.68ug/kg/h to maintain a surgical level of anaesthesia. The mean time from stopping the anaesthetic agents until the patients opened the eyes and responded to verbal commands were 2.20 minutes and 2.70 minutes respectively. The study found that Propofol and remifentanil infusions at a rate of 5.44mg/kg/h and 13.68ug/kg/h respectively, under BIS monitor, effectively controls intraoperative responses and allow for rapid emergence from anaesthesia in a Ghanaian population.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population
AU  - Akwasi Antwi-Kusi
AU  - Bright Ighodaro Obasuyi
Y1  - 2017/02/06
PY  - 2017
N1  - https://doi.org/10.11648/j.ja.20170501.11
DO  - 10.11648/j.ja.20170501.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20170501.11
AB  - General anaesthesia is a balance between the amount of anaesthetic drug(s) administered and the state of arousal of the patient. Different patients may need variable doses of anaesthetics to reach and maintain a surgical level of anaesthesia. Even though lack of autonomic response suggests sufficient analgesia during surgery, there is no such clear clinical sign for the assessment of the depth and sedation of anaesthesia especially in a paralysed patient. Bispectra index (BIS) monitors the depth of anaesthesia and helps the anaesthetist to deliver the minimal dose of anaesthetic agent required to achieve an adequate hypnotic state. In this study conducted at the Komfo Anokye Teaching Hospital, patients undergoing general anaesthesia received intravenous propofol and remifentanil under BIS monitor as the sole anaeshetic. At the end of the surgery the total amount of propofol and remifentanil consumed and the time it took for the patients to open the eye and respond to verbal commands were noted. Propofol consumption was calculated to beat an averagerate of 5.44mg/kg/h and remifentanil at 13.68ug/kg/h to maintain a surgical level of anaesthesia. The mean time from stopping the anaesthetic agents until the patients opened the eyes and responded to verbal commands were 2.20 minutes and 2.70 minutes respectively. The study found that Propofol and remifentanil infusions at a rate of 5.44mg/kg/h and 13.68ug/kg/h respectively, under BIS monitor, effectively controls intraoperative responses and allow for rapid emergence from anaesthesia in a Ghanaian population.
VL  - 5
IS  - 1
ER  -

Copy | Download

Author Information

Akwasi Antwi-Kusi

Department of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Kumasi, Ghana
Bright Ighodaro Obasuyi

Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi. (2017). Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. International Journal of Anesthesia and Clinical Medicine, 5(1), 1-4. https://doi.org/10.11648/j.ja.20170501.11

Copy | Download

ACS Style

Akwasi Antwi-Kusi; Bright Ighodaro Obasuyi. Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. Int. J. Anesth. Clin. Med. 2017, 5(1), 1-4. doi: 10.11648/j.ja.20170501.11

Copy | Download

AMA Style

Akwasi Antwi-Kusi, Bright Ighodaro Obasuyi. Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population. Int J Anesth Clin Med. 2017;5(1):1-4. doi: 10.11648/j.ja.20170501.11

Copy | Download

@article{10.11648/j.ja.20170501.11,
  author = {Akwasi Antwi-Kusi and Bright Ighodaro Obasuyi},
  title = {Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {5},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ja.20170501.11},
  url = {https://doi.org/10.11648/j.ja.20170501.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ja.20170501.11},
  abstract = {General anaesthesia is a balance between the amount of anaesthetic drug(s) administered and the state of arousal of the patient. Different patients may need variable doses of anaesthetics to reach and maintain a surgical level of anaesthesia. Even though lack of autonomic response suggests sufficient analgesia during surgery, there is no such clear clinical sign for the assessment of the depth and sedation of anaesthesia especially in a paralysed patient. Bispectra index (BIS) monitors the depth of anaesthesia and helps the anaesthetist to deliver the minimal dose of anaesthetic agent required to achieve an adequate hypnotic state. In this study conducted at the Komfo Anokye Teaching Hospital, patients undergoing general anaesthesia received intravenous propofol and remifentanil under BIS monitor as the sole anaeshetic. At the end of the surgery the total amount of propofol and remifentanil consumed and the time it took for the patients to open the eye and respond to verbal commands were noted. Propofol consumption was calculated to beat an averagerate of 5.44mg/kg/h and remifentanil at 13.68ug/kg/h to maintain a surgical level of anaesthesia. The mean time from stopping the anaesthetic agents until the patients opened the eyes and responded to verbal commands were 2.20 minutes and 2.70 minutes respectively. The study found that Propofol and remifentanil infusions at a rate of 5.44mg/kg/h and 13.68ug/kg/h respectively, under BIS monitor, effectively controls intraoperative responses and allow for rapid emergence from anaesthesia in a Ghanaian population.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Bispectral Index Guided Propofol and Remifentanil Anaesthesia: Evaluation of Drug Consumption and Immediate Recovery in a Ghanaian Population
AU  - Akwasi Antwi-Kusi
AU  - Bright Ighodaro Obasuyi
Y1  - 2017/02/06
PY  - 2017
N1  - https://doi.org/10.11648/j.ja.20170501.11
DO  - 10.11648/j.ja.20170501.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ja.20170501.11
AB  - General anaesthesia is a balance between the amount of anaesthetic drug(s) administered and the state of arousal of the patient. Different patients may need variable doses of anaesthetics to reach and maintain a surgical level of anaesthesia. Even though lack of autonomic response suggests sufficient analgesia during surgery, there is no such clear clinical sign for the assessment of the depth and sedation of anaesthesia especially in a paralysed patient. Bispectra index (BIS) monitors the depth of anaesthesia and helps the anaesthetist to deliver the minimal dose of anaesthetic agent required to achieve an adequate hypnotic state. In this study conducted at the Komfo Anokye Teaching Hospital, patients undergoing general anaesthesia received intravenous propofol and remifentanil under BIS monitor as the sole anaeshetic. At the end of the surgery the total amount of propofol and remifentanil consumed and the time it took for the patients to open the eye and respond to verbal commands were noted. Propofol consumption was calculated to beat an averagerate of 5.44mg/kg/h and remifentanil at 13.68ug/kg/h to maintain a surgical level of anaesthesia. The mean time from stopping the anaesthetic agents until the patients opened the eyes and responded to verbal commands were 2.20 minutes and 2.70 minutes respectively. The study found that Propofol and remifentanil infusions at a rate of 5.44mg/kg/h and 13.68ug/kg/h respectively, under BIS monitor, effectively controls intraoperative responses and allow for rapid emergence from anaesthesia in a Ghanaian population.
VL  - 5
IS  - 1
ER  -

Copy | Download