Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass
Minimum alveolar concentration (MAC) of volatile anesthetic agents to maintain bispectral index (BIS) below 50 in 50% of patients was defined as MACBIS50. The primary objective of this study was to determine the minimum alveolar concentration of sevoflurane as a single hypnotic agent to maintain BIS...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2021-08, Vol.35 (8), p.2447-2453 |
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| container_title | Journal of cardiothoracic and vascular anesthesia |
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| creator | dos Santos Silva, Carlos Gustavo Neto, Caetano Nigro Hirata, Mario Hiroyuki Tardelli, Maria Angela Bastos, Gisele Medeiros França, Joao Italo Dias Cardoso, Thiago Augusto Azevedo Maranhão |
| description | Minimum alveolar concentration (MAC) of volatile anesthetic agents to maintain bispectral index (BIS) below 50 in 50% of patients was defined as MACBIS50. The primary objective of this study was to determine the minimum alveolar concentration of sevoflurane as a single hypnotic agent to maintain BIS below 50 in patients during normothermic cardiopulmonary bypass.
Prospective and observational study.
Dante Pazzanese Institute of Cardiology, Brazil.
Eighteen consecutive patients scheduled for elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under general anesthesia, American Society of Anesthesiologists physical status classes III and IV, between the ages of 40 and 70, were included in the study.
All patients underwent inhalation induction with facial mask using sevoflurane (Cristália) in 100% oxygen, pancuronium (Cristália) 0.1 mg/kg, and sufentanil (Cristália) 0.5 µg/kg intravenously (IV) administered. A single bolus dose of sufentanil, 1.0 µg/kg IV, was administered before surgical incision. MACBIS50 was calculated using the midpoint concentration of patients involving a crossover (BIS < or ≥50) according to Dixon's Up-and-Down method. The Up-and-Down sequence also was analyzed by probit test that enabled the authors to obtain the effective dose 50 (ED50) and effective dose 95 (ED95) of sevoflurane to maintain a BIS value |
| doi_str_mv | 10.1053/j.jvca.2020.12.032 |
| format | Article |
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Prospective and observational study.
Dante Pazzanese Institute of Cardiology, Brazil.
Eighteen consecutive patients scheduled for elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under general anesthesia, American Society of Anesthesiologists physical status classes III and IV, between the ages of 40 and 70, were included in the study.
All patients underwent inhalation induction with facial mask using sevoflurane (Cristália) in 100% oxygen, pancuronium (Cristália) 0.1 mg/kg, and sufentanil (Cristália) 0.5 µg/kg intravenously (IV) administered. A single bolus dose of sufentanil, 1.0 µg/kg IV, was administered before surgical incision. MACBIS50 was calculated using the midpoint concentration of patients involving a crossover (BIS < or ≥50) according to Dixon's Up-and-Down method. The Up-and-Down sequence also was analyzed by probit test that enabled the authors to obtain the effective dose 50 (ED50) and effective dose 95 (ED95) of sevoflurane to maintain a BIS value <50, with a 95% confidence interval (95% CI) of the mean.
A total of 15 patients were analyzed in this study. MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% (95% CI 0.47-1.16) in patients aged 40 to 70 undergoing CABG during normothermic CPB. The ED50 and ED95 of sevoflurane to maintain a BIS value <50 for the same context were 0.73% (95% CI 0.45-1.00) and 1.39 (95% CI 0.42-2.37) by means of probit analysis, respectively.
MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% in patients undergoing CABG during normothermic CPB.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2020.12.032</identifier><identifier>PMID: 33483271</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>cardiopulmonary bypass ; coronary artery bypass grafting ; inhalation anesthesia ; MACBIS50 ; sevoflurane</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2021-08, Vol.35 (8), p.2447-2453</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-c3ba442a122c4ceed338556666c6a6e283b300dc271652b5c25a4829b2a71c933</citedby><cites>FETCH-LOGICAL-c356t-c3ba442a122c4ceed338556666c6a6e283b300dc271652b5c25a4829b2a71c933</cites><orcidid>0000-0002-8165-4297</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jvca.2020.12.032$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33483271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>dos Santos Silva, Carlos Gustavo</creatorcontrib><creatorcontrib>Neto, Caetano Nigro</creatorcontrib><creatorcontrib>Hirata, Mario Hiroyuki</creatorcontrib><creatorcontrib>Tardelli, Maria Angela</creatorcontrib><creatorcontrib>Bastos, Gisele Medeiros</creatorcontrib><creatorcontrib>França, Joao Italo Dias</creatorcontrib><creatorcontrib>Cardoso, Thiago Augusto Azevedo Maranhão</creatorcontrib><title>Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Minimum alveolar concentration (MAC) of volatile anesthetic agents to maintain bispectral index (BIS) below 50 in 50% of patients was defined as MACBIS50. The primary objective of this study was to determine the minimum alveolar concentration of sevoflurane as a single hypnotic agent to maintain BIS below 50 in patients during normothermic cardiopulmonary bypass.
Prospective and observational study.
Dante Pazzanese Institute of Cardiology, Brazil.
Eighteen consecutive patients scheduled for elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under general anesthesia, American Society of Anesthesiologists physical status classes III and IV, between the ages of 40 and 70, were included in the study.
All patients underwent inhalation induction with facial mask using sevoflurane (Cristália) in 100% oxygen, pancuronium (Cristália) 0.1 mg/kg, and sufentanil (Cristália) 0.5 µg/kg intravenously (IV) administered. A single bolus dose of sufentanil, 1.0 µg/kg IV, was administered before surgical incision. MACBIS50 was calculated using the midpoint concentration of patients involving a crossover (BIS < or ≥50) according to Dixon's Up-and-Down method. The Up-and-Down sequence also was analyzed by probit test that enabled the authors to obtain the effective dose 50 (ED50) and effective dose 95 (ED95) of sevoflurane to maintain a BIS value <50, with a 95% confidence interval (95% CI) of the mean.
A total of 15 patients were analyzed in this study. MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% (95% CI 0.47-1.16) in patients aged 40 to 70 undergoing CABG during normothermic CPB. The ED50 and ED95 of sevoflurane to maintain a BIS value <50 for the same context were 0.73% (95% CI 0.45-1.00) and 1.39 (95% CI 0.42-2.37) by means of probit analysis, respectively.
MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% in patients undergoing CABG during normothermic CPB.</description><subject>cardiopulmonary bypass</subject><subject>coronary artery bypass grafting</subject><subject>inhalation anesthesia</subject><subject>MACBIS50</subject><subject>sevoflurane</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1uEzEUhUcIREvhBVggL9kk2Nf2zFRik6RAK7WAlHZteTw3xZFnPNgzqfImPC43SttlLflX3znyvacoPgo-F1zLL9v5dufsHDjQA8y5hFfFqdASZrUCeE1noma8qvhJ8S7nLedCaF29LU6kVLWESpwW_25877upY4uwwxhsYqvYO-zHZEcfexY3bI27uAlTsj0ym5lla9_fB2SX-6GPo3dscU88GyO7sb4fabLl1ZotMcQHpjmj-28yIyaziymRmP2MqYvjH0wdyVc2tT4OU-hib9OeLfeDzfl98WZjQ8YPj_tZcff92-3qcnb968fVanE9c1KXI62NVQqsAHDKIbZS1lqXNFxpS4RaNpLz1lGxpYZGO9BW1XDegK2EO5fyrPh89B1S_DthHk3ns8MQqNw4ZQOq5lDVXClC4Yi6FHNOuDFD8h192QhuDr02W3NIxBwSMQIMJUKiT4_-U9Nh-yx5ioCAr0cAqcqdx2Syo2Y5bH1CN5o2-pf8_wPM5p2u</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>dos Santos Silva, Carlos Gustavo</creator><creator>Neto, Caetano Nigro</creator><creator>Hirata, Mario Hiroyuki</creator><creator>Tardelli, Maria Angela</creator><creator>Bastos, Gisele Medeiros</creator><creator>França, Joao Italo Dias</creator><creator>Cardoso, Thiago Augusto Azevedo Maranhão</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8165-4297</orcidid></search><sort><creationdate>20210801</creationdate><title>Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass</title><author>dos Santos Silva, Carlos Gustavo ; Neto, Caetano Nigro ; Hirata, Mario Hiroyuki ; Tardelli, Maria Angela ; Bastos, Gisele Medeiros ; França, Joao Italo Dias ; Cardoso, Thiago Augusto Azevedo Maranhão</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-c3ba442a122c4ceed338556666c6a6e283b300dc271652b5c25a4829b2a71c933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>cardiopulmonary bypass</topic><topic>coronary artery bypass grafting</topic><topic>inhalation anesthesia</topic><topic>MACBIS50</topic><topic>sevoflurane</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>dos Santos Silva, Carlos Gustavo</creatorcontrib><creatorcontrib>Neto, Caetano Nigro</creatorcontrib><creatorcontrib>Hirata, Mario Hiroyuki</creatorcontrib><creatorcontrib>Tardelli, Maria Angela</creatorcontrib><creatorcontrib>Bastos, Gisele Medeiros</creatorcontrib><creatorcontrib>França, Joao Italo Dias</creatorcontrib><creatorcontrib>Cardoso, Thiago Augusto Azevedo Maranhão</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>dos Santos Silva, Carlos Gustavo</au><au>Neto, Caetano Nigro</au><au>Hirata, Mario Hiroyuki</au><au>Tardelli, Maria Angela</au><au>Bastos, Gisele Medeiros</au><au>França, Joao Italo Dias</au><au>Cardoso, Thiago Augusto Azevedo Maranhão</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>35</volume><issue>8</issue><spage>2447</spage><epage>2453</epage><pages>2447-2453</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Minimum alveolar concentration (MAC) of volatile anesthetic agents to maintain bispectral index (BIS) below 50 in 50% of patients was defined as MACBIS50. The primary objective of this study was to determine the minimum alveolar concentration of sevoflurane as a single hypnotic agent to maintain BIS below 50 in patients during normothermic cardiopulmonary bypass.
Prospective and observational study.
Dante Pazzanese Institute of Cardiology, Brazil.
Eighteen consecutive patients scheduled for elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) under general anesthesia, American Society of Anesthesiologists physical status classes III and IV, between the ages of 40 and 70, were included in the study.
All patients underwent inhalation induction with facial mask using sevoflurane (Cristália) in 100% oxygen, pancuronium (Cristália) 0.1 mg/kg, and sufentanil (Cristália) 0.5 µg/kg intravenously (IV) administered. A single bolus dose of sufentanil, 1.0 µg/kg IV, was administered before surgical incision. MACBIS50 was calculated using the midpoint concentration of patients involving a crossover (BIS < or ≥50) according to Dixon's Up-and-Down method. The Up-and-Down sequence also was analyzed by probit test that enabled the authors to obtain the effective dose 50 (ED50) and effective dose 95 (ED95) of sevoflurane to maintain a BIS value <50, with a 95% confidence interval (95% CI) of the mean.
A total of 15 patients were analyzed in this study. MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% (95% CI 0.47-1.16) in patients aged 40 to 70 undergoing CABG during normothermic CPB. The ED50 and ED95 of sevoflurane to maintain a BIS value <50 for the same context were 0.73% (95% CI 0.45-1.00) and 1.39 (95% CI 0.42-2.37) by means of probit analysis, respectively.
MACBIS50 of sevoflurane as a single hypnotic agent was 0.82% in patients undergoing CABG during normothermic CPB.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33483271</pmid><doi>10.1053/j.jvca.2020.12.032</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8165-4297</orcidid></addata></record> |
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| subjects | cardiopulmonary bypass coronary artery bypass grafting inhalation anesthesia MACBIS50 sevoflurane |
| title | Minimum Alveolar Concentration of Sevoflurane as a Single Hypnotic Agent to Maintain BIS Below 50 in Patients During Normothermic Cardiopulmonary Bypass |
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