The Influence Of Different Doses Of Rocuronium On BIS Under Different Propofol Calm Level

Objective:Comparative the effect of different doses of rocuronium on BIS index responses to propofol induction and tracheal intubation. Analysis and investigate the relationship of non-depolarization muscle relaxant rocuronium and depth of sedation.Methods:72ASA I～II patients undergoing general anesthesia elective surgery descending tracheal intubation were involved, aged from20-60, all patients were inducted by propofol TCI with initial target concentration of3.0μg/ml, All patients were randomly divided into two sedation level groups according BIS value with adjustment of propofol target concentration every4minute increased0.5μg/ml, group1,(normal sedation group, n=36), BIS value stability at40-60,group2(deep sedation group, n=36), BIS value under20or appearing burst suppression. Maintaining target BIS value for4minutes, and when the plasma and effect concentration is equal, which define as stability, then the target concentration no longer changed. After reaching stability, two groups were randomly divide into four subgroups according different infusion of rocuronium ((0.3,0.6,0.9.1.2mg/kg), group A.B,C.D(N=9), tracheal intubation was performed2minutes after rocuronium administration. BIS, EMG, HR and MAP were recorded continuously and averaged over1min during baseline (T1)、steady state (T2)、2minutes after rocuronium infusion (T3) and0、2、5minutes after tracheal intubation(L0,L2and L5). All data were used as offline analysis.Results:1HR and MAP decreased obviously at T2and T3compared with Tl in each group (P<0.05); After tracheal intubation (LO) HR and MAP significantly increased compared with T2and T3(P<0.05).2. In group1C and1D, BIS value was significantly decreased at T3(40±8,42±6) compared with T2(50±6,54±4)(P<0.05); BIS value was increased obviously at LO (71±8,59±6) compared with T3(50±5,48±8) in group1A and1B (P<0.05).3. EMG was significantly increased at LO (40±6,36±6) compare with T3(29±8.28±4) in group1A and1B (P<0.05).Conclusions:1. It seems that rocuronium dose-dependently suppresses the BIS index response to tracheal intubation under normal sedation (BIS=40-60), muscle relaxation may confound interpretation of BIS monitor.2. Rocuronium lose that inhibition effect on BIS index during deep sedation (BIS<20or occur burst suppression).3. Tracheal intubation results in obvious hemodynamic change both under normal sedation and deep sedation and rocuronium dose does not exhibit inhibition effect.