Arousal with iv epinephrine depends on the depth of anesthesia

Hye Won Shin, Young Jun Ban, Hye Won Lee, Hae Ja Lim, Suk Min Yoon, Seong Ho Chan

    Research output: Contribution to journalArticlepeer-review

    16 Citations (Scopus)


    Purpose: To investigate whether the depth of anesthesia affects the change in the bispectral index (BIS) caused by iv epinephrine during propofol anesthesia. Methods: Forty women undergoing elective lower abdominal surgery received a propofol target controlled infusion (TCI) to maintain a modified Observer's Assessment of Alertness/Sedation (OAA/S) score of 2 (sedation period). Subsequently anesthesia was induced with propofol TCI 5 μg·mL-1 and rocuronium 0.9 mg·kg-1, and propofol continued so as to maintain general anesthesia at a BIS of 50 (general anesthesia period). Intravenous epinephrine at a dose of 10 μg·5 mL-1 in normal saline (epinephrine group, n = 20) or normal saline 5 mL (control group, n = 20) was administered during both periods. The BIS, mean arterial pressure (MAP) and heart rate (HR) were measured immediately before, and one, two, three, four, six, eight, and ten minutes after injection. The modified OAA/S scale was evaluated during the sedation period. Results: There was no significant change in the modified OAA/S scale, BIS, or hemodynamic variables compared to preinjection values during either sedation or general anesthesia in the control group. Intravenous epinephrine increased the BIS and modified OAA/S scale during sedation, but there was no increase in BIS during general anesthesia. Increases in HR and MAP were observed during both periods after iv epinephrine. Conclusion: Intravenous epinephrine 10 μg resulted in an arousal effect and an increase in BIS during sedation, but did not change the BIS during general anesthesia. These results suggest that the arousal effect of iv epinephrine during propofol anesthesia depends on anesthetic depth.

    Original languageEnglish
    Pages (from-to)880-885
    Number of pages6
    JournalCanadian Journal of Anesthesia
    Issue number9
    Publication statusPublished - 2004 Nov

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine


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