Comparison of Hemodynamic Effects of Dose Response vs. Conventional Dosing of Propofol for Anesthesia Induction Under Bispectral Index Monitoring: A Clinical Trial

Zahra Khazaeipour; Niloufar Khoshnam-Rad; Khalil Pestei; Shahram Samadi

doi:10.18502/acta.v61i9.15287

Zahra Khazaeipour Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Niloufar Khoshnam-Rad Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Khalil Pestei Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Shahram Samadi Anesthesia, Critical Care and Pain Management Research Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v61i9.15287

Keywords: Bispectral index; Propofol; Hemodynamic adverse effects

Abstract

Propofol is an advantageous agent for anesthesia induction. It can cause dose-related hemodynamic adverse effects. The bispectral index (BIS) is a brain function monitor utilized to assess the depth of anesthesia. This study aimed to compare the adverse hemodynamic effects of BIS-guided response dosing with conventional weight-based dosing of Propofol. In this clinical trial, patients were anesthetized with propofol in two different orthopedic operating rooms. In one operating room, patients received propofol with dose-response method (group A), and the other received weight-based dosing (group B). For both groups, BIS was used as an index of anesthesia depth. Hemodynamic parameters were recorded at baseline, during induction, and at different time points. A total of 73 patients were included in the final analysis. The mean dose of propofol for induction was higher in the control group than in the response-guided group (1.94±1.65 vs. 1.09±0.32, respectively, P=0.006). There were no reported significant adverse hemodynamic effects in patients of the two groups. Response-guided propofol dosing can be used to decrease propofol dose during anesthesia induction. Further studies are needed to investigate the clinical benefit of this dosing strategy.