Key result
Epidural anesthesia reduces propofol induction dose by ~31% but Bispectral Index misses this sedative effect.
Why the study?
Epidural anesthesia has a direct sedative effect and reduces hypnotic agent requirements, but it is unclear if BIS monitoring detects this sedative effect during propofol induction.
Does epidural anesthesia reduce propofol requirements and does BIS monitoring detect its sedative effect in patients undergoing lower abdominal surgery?
RCT (n=20)
No
Does epidural anesthesia reduce propofol requirements and does BIS monitoring detect its sedative effect in patients undergoing lower abdominal surgery?
Absolute Event Rate: 1.1% vs 1.6%
p-value: p=<0.05
Epidural anesthesia reduces the required dose of propofol for hypnosis, but BIS monitoring fails to detect the sedative effect induced by epidural anesthesia.
BIS may miss epidural-induced sedation during propofol induction; leaves open its reliability for combined regional-intravenous anesthesia.
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Shin et al. (2002) conducted an RCT in Elective lower abdominal surgery (n=20). Epidural anesthesia vs. No epidural anesthesia was evaluated on Hypnotic dose of propofol (mg/kg) (p=<0.05). Epidural anesthesia significantly decreased the hypnotic dose of propofol required for induction (1.1 vs 1.6 mg/kg) but Bispectral Index monitoring failed to detect this sedative effect.
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