• Yoshinori Kanemaru, Koichi Nishikawa, and Fumio Goto.
• Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi City 371-8511, Japan.
• Can J Anaesth. 2006 Apr 1;53(4):363-9.

PurposeA study was undertaken to compare the influence of midazolam, isoflurane, and aminophylline (which may antagonize anesthetic action) on bispectral index (BIS) and regional cerebral oxygen saturation (rSO(2)) during propofol/N(2)O anesthesia, and to test the hypothesis that the drug-induced changes in BIS values are accompanied by a change in rSO(2).MethodsGeneral anesthesia was administered to 36 patients with a continuous infusion of propofol to maintain a BIS value of 40 +/- 5. After baseline recordings, patients were randomly assigned to receive either midazolam, isoflurane, or aminophylline. Bispectral index values, rSO(2) using near-infrared spectroscopy, and hemodynamic parameters were recorded for 60 min.ResultsMidazolam (0.05 mg x kg(-1)) significantly decreased the BIS from 47.8 +/- 5.4 to 35.0 +/- 4.5 at five minutes after injection (P < 0.001 vs control) during propofol anesthesia, whereas the rSO(2) was unchanged. Similarly, isoflurane (1.1% end-tidal) decreased the BIS from 42.5 +/- 7.5 to 27.8 +/- 6.9 (P < 0.001) without affecting rSO(2). In contrast, aminophylline (3 mg.kg(-1)) was associated with an increase in BIS from 41.6 +/- 2.1 to 48.3 +/- 9.2 at five minutes after injection (P < 0.05) without affecting rSO(2).ConclusionsMidazolam or isoflurane-induced decreases in the BIS during propofol anesthesia were not accompanied by a decrease in rSO(2). Aminophylline significantly increased the BIS score during propofol anesthesia, suggesting that aminophylline can antagonize, at least in part, the sedative actions of propofol.

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