척추교정수술 중 Wake-Up Test 동안 Desflurane과 Sevoflurane 마취에 의한 이중분광지수(Bispectral Index)와 환자반응의 관계

Abstract

Background: Wake-up tests may be necessary during scoliosis or kyphosis surgery to ensure that spinal function remains intact or not. It is difficult to predict the time when the patients respond to verbal command. We evaluated the effectiveness of bispectral indices(BIS) and their relation with the patient's level of consciousness during wake-up test in desflurane or sevoflurane anesthesia. Methods: Eighteen ASA class 1 or 2 patients, were enrolled into either a desflurane group, or a sevoflurane group for spinal correction surgery. A BIS was continuously monitored in all patients throughout the procedure. We measured BIS values, blood pressure, heart rate, consciousness state and the time according to patient's response during wake-up test. Results: Average BIS values in the desflurane group and sevoflurane group were 86.7 ± 7.5 vs. 90.3 ± 5.4 at the time of patient's response to verbal command and 88.7 ± 6.1 vs. 91.4 ± 4.9 at the time of moving toes in a response to verbal command respectively. These times showed no statistically difference between both groups. Patients in the desflurane group had a significantly shorter wake up onset than patients in the sevoflurane group(6.9 ± 1.8 min vs. 11.8 ± 3.6 min). But there is no difference in both groups between the time of the patient's response to verbal command and the time of patient's moving toes in a response to verbal commands(0.2 ± 0.1 min vs. 0.3 ± 0.2 min). No recall occurred during the wake-up test in both groups. Conclusions: Desflurane group had a shorter onset for wake-up test in spinal surgery for correction than sevoflurane group. It would be easier for the anesthesiologist to perform and evaluate wake-up test in desflurane anesthesia.