• Shigeki Yamaguchi, Hirotoshi Egawa, Mutsuo Mishio, Yasuhisa Okuda, and Toshimitsu Kitajima.
• Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
• J Clin Anesth. 2003 Feb 1;15(1):24-8.

Study ObjectiveTo evaluate the variables of bispectral index (BIS) values during vital capacity rapid inhalation induction (VCRII) with sevoflurane.DesignRandomized, prospective study.SettingUniversity hospital.Patients40 ASA physical status I and II patients scheduled for elective orthopedic surgery with general anesthesia.InterventionsPatients was divided into two groups, both of which received intravenous (IV) injection of propofol 2 mg/kg followed by inhalation of sevoflurane 3% (Group P), or vital capacity inhalation induction with sevoflurane 8% (Group S). After loss of consciousness, tracheal intubation was performed with vecuronium 0.1 mg/kg.Measurements And Main ResultsThe induction times in Group P were significantly shorter than those in Group S (p < 0.01). In Group S, BIS values were gradually decreased and maintained the adequate hypnotic levels were maintained during induction. In Group P, although BIS values were rapidly decreased, the values remained higher compared with Group S. The BIS value before intubation in Group S was significantly lower than that in Group P (25 +/- 9 and 38 +/- 7, respectively; p < 0.01). Five of 20 Group P patients had BIS values exceeding 60 before tracheal intubation, but no patient in Group S had a BIS value as high. Mean arterial pressure immediately after intubation in Group S was significantly lower than that in Group P (p < 0.05).ConclusionVCRII with a high concentration of sevoflurane provided adequate BIS values during induction, suggesting that it may allow smoother transition from anesthesia induction to maintenance, and also maintain an adequate hypnotic level in readiness for certain stimuli such as laryngoscopy and tracheal intubation.

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