Masui. The Japanese journal of anesthesiology
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We studied the changes in the bispectral index (BIS) of 22 patients during electroconvulsive therapy (ECT) under propofol and succinylcholine anesthesia. BIS values (mean+/-SD) were 94+/-4 before anesthesia, 51+/-15 before ECT, 49+/-20 after ECT, and 60+/-17 at complete re-awakening. The BIS values at re-awakening were significantly different from those before anesthesia (P<0.05). In conclusion, our study suggests that the BIS values following ECT might not reliably correlate with the patients' clinical level of consciousness.
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Case Reports
[Withdrawal syndrome in a critically ill child after sedation with midazolam and fentanyl].
A 7-year-old girl suffered from withdrawal syndrome with systemic convulsion after sedation with midazolam and fentanyl. She had a history of severe accidental alkaline esophagitis, and under went polysurgeries. This time, she was scheduled to receive reconstruction of the esophagus with small intestine in order to resolve esophageal stenosis. ⋯ There was no evidence of obvious organic central nervous system abnormality. We suspected withdrawal syndrome, and gradual decrease of midazolam and fentanyl prevented her from going into withdrawal syndrome. We have to pay attention to withdrawal syndrome when heavy and long sedation with midazolam and fentanyl was employed and the drugs were then tapered and discontinued.