한국인에서 Propofol 의 효과처 농도 ( Effect site concentration ) 에 상응하는 BIS 및 OAA/S Scale

• Published in: Korean journal of anesthesiology Vol. 38; no. 2; pp. 251 - 257
• Main Authors: 이동호, Dong Ho Lee, 이성우, Sung Woo Lee, 길호영, Ho Yeong Kil, 이성익, Seong Ik Lee, 이승준, Seung Joon Lee
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 28-02-2000
• Subjects: Anesthetic equipment; bispectral index; effect site concentration. Sedation; monitoring device. Pharmacology; OAA/S (modified observer`s assessment of alertness/sedation) scale
• ISSN: 2005-6419; 2005-7563

Background : Propofol has been frequently used for sedation or hypnosis in anesthesia and is relatively accurate in the dose-response relationship for hypnosis. The aim of this study was to define the bispectral index and modified observers assessment of alertness/sedation (OAA/S) scale at various effect site con- centrations (C,) of propofol in Koreans. Methods : Fifty premedicated (atropine 0.5 mg, I.M.) adult patients (ASA class I or II, 20 - 55 yrs) scheduled for elective orthopedic surgery were studied. Propofol was infused until 2 min after the target concentration equilibrated with the effect site concentration (C,) of propofol using Master TCI. The target concentration for propofol was stepwise increased at intervals of 0.5 mg/ml until BIS reached 40, BIS and OAA/S at each C, of propofol were checked. If SpO2 decreased below 90%, oxygen (4 1/min) was given via nasal cannula.
Results : BIS was 97.9 + 0.2 and OAA/S 5±0.0 at a C, of propofol of 0 mg/ml; the C. of propofol was 3.5 mg/ml and OAA/S 0.1 ± 0.3 at a BIS of 41.1 ± 2.5. Also, systolic BP at a C. of propofol above 1.0 mg/ml and diasolic BP at a C. of propofol above 1.5 mg/ml significantly decreased compared to the control (P < 0.05). However, heart rate did not show any difference compared to the control value. Above a 1.0 mg/ml C fifty-eight percent of patients showed SpO2 < 90%, but there was no incidence of apnea. There were significant correlations between C, of propofol, BIS and OAA/S. Conclusions : BIS showed a significant correlation with C. of propofol (Spearman's r =- 1.0) (P < 0.000l). The C, of propofol was above 3.0 pg/ml for BISso. (Korean J Anesthesiol 2000; 38: 251-257)