Comparison of Hemodynamic Effects of Dose Response vs. Conventional Dosing of Propofol for Anesthesia Induction Under Bispectral Index Monitoring: A Clinical Trial

Propofol is an advantageous agent for anesthesia induction. It can cause dose-related hemodynamic adverse effects. The bispectral index (BIS) is a brain function monitor utilized to assess the depth of anesthesia. This study aimed to compare the adverse hemodynamic effects of BIS-guided response dosing with conventional weight-based dosing of Propofol. In this clinical trial, patients were anesthetized with propofol in two different orthopedic operating rooms. In one operating room, patients received propofol with dose-response method (group A), and the other received weight-based dosing (group B). For both groups, BIS was used as an index of anesthesia depth. Hemodynamic parameters were recorded at baseline, during induction, and at different time points. A total of 73 patients were included in the final analysis. The mean dose of propofol for induction was higher in the control group than in the response-guided group (1.94±1.65 vs. 1.09±0.32, respectively, P=0.006). There were no reported significant adverse hemodynamic effects in patients of the two groups. Response-guided propofol dosing can be used to decrease propofol dose during anesthesia induction. Further studies are needed to investigate the clinical benefit of this dosing strategy.