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Variation of bispectral index under TIVA with propofol in a paediatric population

O Tirel1, E Wodey, R Harris

  • 1INSERM, U642, F-35000 Rennes, France. olivier.tirel@chu-rennes.fr

British Journal of Anaesthesia
|December 12, 2007
PubMed

Insights

Age significantly impacts bispectral index (BIS) values during propofol anesthesia in children, particularly at lower concentrations. This highlights challenges in interpreting BIS during pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacokinetics

Background:

  • The bispectral index (BIS) is used to monitor anesthetic depth.
  • Propofol is a common anesthetic agent used in pediatric patients.
  • Understanding BIS behavior at varying propofol concentrations is crucial for safe anesthesia.

Purpose of the Study:

  • To investigate the relationship between age and BIS values.
  • To explore BIS response to different plasma propofol concentrations in children.
  • To assess the interpretability of BIS during pediatric propofol anesthesia.

Main Methods:

  • Prospective observational study in 50 children (3-15 years).
  • Target-controlled infusion of propofol using the Kataria model.
  • Propofol concentrations were sequentially reduced (6, 4, and 2 microg/ml).
  • Continuous recording of BIS, plasma propofol concentration, and EEG.
  • Multiple correspondence analysis (MCA) used to analyze BIS and propofol concentration relationships.

Main Results:

  • No significant difference in BIS values between propofol concentrations of 6 and 4 microg/ml.
  • A significant difference in BIS was observed at 2 microg/ml.
  • A significant correlation (r2=0.66, P<0.01) was found between children's age and BIS values at 2 microg/ml propofol.
  • MCA indicated minimal change in patient position between 6 and 4 microg/ml, with movement primarily on axis 2 from 4 to 2 microg/ml.

Conclusions:

  • Interpreting BIS values can be challenging due to minimal changes at higher propofol concentrations.
  • The correlation between age and BIS at lower propofol concentrations complicates interpretation.
  • Age is a significant factor influencing BIS values in pediatric patients during propofol anesthesia.
Abstract

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