%0 Journal Article
%T Short-term Inhalation of Sevoflurane during Induction of General Anesthesia Can Inhibit the A-line ARX Index Response to Intubation: A Randomized Trial
%A Ching-Feng Lin
%A Ching-Yue Yang
%A Edison Chao
%A Mel S. Lee
%J Chang Gung Medical Journal
%D 2011
%I 
%X Background: Monitoring hypnotic depth is used to prevent awareness during general anesthesia. We used the A-line ARX index (AAI) to assess the effect of shortterm inhalation of sevoflurane in the prevention of intubation-induced inadequate hypnotic depth during anesthetic induction.Methods: Thirty patients were randomly divided into the sevoflurane and non-sevoflurane groups, both of which were given 3 ¦Ìg kg-1fentanyl, 4 mg kg-1thiamylal, and 0.2 mg kg-1cis-atracurium intravenously to induce general anesthesia. The sevoflurane group then inhaled 6% sevoflurane and 4 L/min O2for 3minutes, whereas the non-sevoflurane group was given 4 L/min O2alone.Both groups were intubated 3 minutes after induction. Measurements of theAAI, non-invasive blood pressure, and heart rate were performed everyminute, starting 3 minutes prior to induction until 9 minutes after intubation.Results: Intubation induced a significant AAI elevation in the non-sevoflurane group(47.13   20.88, 48.13   20.05, 40.87   15.86 and 31.27   15.26 at 1, 2, 3and 4 minutes after intubation, respectively, vs. 17.67   6.44 at 3 minutesafter induction; p < 0.05), whereas the AAI remained unchanged for thesevoflurane group following intubation. Moreover, the non-sevofluranegroup demonstrated higher AAI values after intubation compared with thesevoflurane group. There were no significant differences in blood pressureand heart rate between the two groups throughout the study.Conclusion: Adding 6% sevoflurane with 4 L/min O2for 3 minutes during the inductionperiod prevented inadequate hypnotic depth caused by intubation but was notsufficient to inhibit fluctuations in hemodynamics.
%K A-line ARX index
%K hypnotic depth
%K awareness
%K intubation
%K sevoflurane
%U http://memo.cgu.edu.tw/cgmj/3406/340605.pdf