The Effect of Fentanyl on Hemodynamic and Bispectral Index Changes During Anesthesia Induction With Propofol

Introduction: BIS monitors are noninvasive devices that reect a signal processed EEG. Since the introduction of bispectral index in 1992, it has steadily gained clinical acceptance as a reliable measure to monitor the effects of anaesthesia and sedation on the brain. The BIS may be used as aid in monitoring the effects of certain anaesthetic agents; and its usage with certain anaesthetic agents may be associated with a reduction in primary anaesthetic use and a reduction in emergence and recovery time. Use of BIS monitoring to guide anaesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults during general anaesthesia and sedation. To observed THE EFFECT OF Aims: FENTANYL ON HEMODYNAMIC AND BISPECTRAL INDEX CHANGES DURING ANESTHESIA INDUCTION WITH PROPOFOL. Material And Method: 40 ASA physical status I, II patients (30-60 years of age) scheduled for elective surgery are involved in this study. Patients are divided into two groups 1. Group P : receive only propofol (Inj. Propofol 20 mg/kg/hr for 10 minutes) (n= 20), 2. Group PF : propofol + fentanyl (Inj. Propofol 20 mg/kg/hr for 10 minutes + Inj. Fentanyl 2 mcg/kg. IV in PF group) (n=20). Results: Mean arterial blood pressure during Induction, Intubation and 10 min after Intubation in PF group were 93.90±8.045 mmHg, 90.53±11.106 mmHg and 92.96±7.294 mmHg respectively compared to P group were 96.50±7.222 mmHg, 96.00±9.711 mmHg and 98.45±5.157 mmHg respectively. Mean BIS score during Induction, Intubation and 10 min after Intubation in PF group were 100.0±0.000, 55.10±2.947 and 56.55±2.854 respectively compared to P group 100.0±0.000, 54.35±3.424 and 54.20±2.420 respectively. Conclusion: This study shows that fentanyl modies hemodynamic changes during induction of anaesthesia with Propofol without affecting BIS response. Propofol administration at a rate of 20mg/kg/hr for 10-minute period is suitable for achieving unconsciousness and suppression of arousal reaction to tracheal intubation. However, the addition of fentanyl is required to blunt the hemodynamic response to intubation.