Influence of S-Ketamine, at low Doses, on the Electroencephalogram - BIS Suppression Rate: A Randomized Clinical Trial

R. Nunes, Filipe Mitsuo Akamine, B. Meireles
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Abstract

Objective: To evaluate the influence of low doses of S-ketamine, during total intravenous anesthesia, on the suppression rate (SR) induced during total intravenous anesthesia (TIVA) by deepening the anesthetic plane. Methods: A triple-blind clinical trial was conducted with 20 patients who underwent elective operations under general anesthesia, randomly allocated into two groups, CG (control: 0.9% saline) and CGS (s-ketamine: 0.2 mg.kg-1). Each group was assessed at M0 (immediately before pre-oxygenation), M1 (3 minutes after SR stabilization) and M2 (3 minutes after infusion of s-ketamine or 0.9% saline). Bispectral index (BIS), electromyography, and SR were recorded at each moment. Results: There were no statistically significant changes regarding BIS and EMG from M1 to M2. There was also no indication of a significant difference between the average SR values concerning the factors group and moment, jointly (p=0.499), and separately (G1 and G2, p=0.812 and p=0.923). Conclusions: Low doses of s-ketamine were insufficient to determine changes in SR values, validating this important electroencephalographic parameter. Significance: The study findings reinforce that low doses of s-ketamine do not invalidate the SR values
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低剂量s -氯胺酮对脑电图BIS抑制率的影响:一项随机临床试验
目的:探讨全静脉麻醉时低剂量s -氯胺酮加深麻醉平面对全静脉麻醉(TIVA)抑制率(SR)的影响。方法:对20例全麻下择期手术患者进行三盲临床试验,随机分为CG组(对照组:0.9%生理盐水)和CGS组(s-氯胺酮:0.2 mg.kg-1)。各组分别在M0(预充氧前立即)、M1 (SR稳定后3分钟)和M2 (s-氯胺酮或0.9%生理盐水输注后3分钟)进行评估。记录各时刻双谱指数(BIS)、肌电图和SR。结果:从M1到M2, BIS和EMG变化无统计学意义。各因素组、各因素组、各因素组(p=0.499)、各因素组(G1和G2, p=0.812和p=0.923)的平均SR值也无显著差异。结论:低剂量s-氯胺酮不足以确定SR值的变化,验证了这一重要的脑电图参数。意义:研究结果强调,低剂量s-氯胺酮不会使SR值失效
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