J Korean Neurosurg Soc.  2011 Dec;50(6):497-502. 10.3340/jkns.2011.50.6.497.

Comparative Study of Brain Protection Effect between Thiopental and Etomidate Using Bispectral Index during Temporary Arterial Occlusion

• Kim TK
• Park IS

• KMID: 2066898
• DOI: http://doi.org/10.3340/jkns.2011.50.6.497

Abstract

OBJECTIVE
This study was conducted to compare the effect of etomidate with that of thiopental on brain protection during temporary vessel occlusion, which was measured by burst suppression rate (BSR) with the Bispectral Index (BIS) monitor.
METHODS
Temporary parent artery occlusion was performed in forty one patients during cerebral aneurysm surgery. They were randomly assigned to one of two groups. General anesthesia was induced and maintained with 1.5-2.5 vol% sevoflurane and 50% N2O. The pharmacological burst suppression (BS) was induced by a bolus injection of thiopental (5 mg/kg, group T) or etomidate (0.3 mg/kg, group E) according to randomization prior to surgery. After administration of drugs, the hemodynamic variables, the onset time of BS, the numerical values of BIS and BSR were recorded at every minutes.
RESULTS
There were no significant differences of the demographics, the BIS numbers and the hemodynamic variables prior to injection of drugs. The durations of burst suppression in group E (11.1+/-6.8 min) were not statistically different from that of group T (11.1+/-5.6 min) and nearly same pattern of burst suppression were shown in both groups. More phenylephrine was required to maintain normal blood pressure in the group T.
CONCLUSION
Thiopental and etomidate have same duration and a similar magnitude of burst suppression with conventional doses during temporary arterial occlusion. These findings suggest that additional administration of either drug is needed to ensure the BS when the temporary occlusion time exceed more than 11 minutes. Etomidate can be a safer substitute for thiopental in aneurysm surgery.

Keyword

Aneurysm; Barbiturate; Bispectral Index (BIS) Burst suppression; Etomidate; Temporary arterial occlusion

MeSH Terms

Anesthesia, General
Aneurysm
Arteries
Barbiturates
Blood Pressure
Brain
Demography
Dietary Sucrose
Etomidate
Glycosaminoglycans
Hemodynamics
Humans
Intracranial Aneurysm
Methyl Ethers
Parents
Phenylephrine
Random Allocation
Thiopental
Barbiturates
Dietary Sucrose
Etomidate
Glycosaminoglycans
Methyl Ethers
Phenylephrine
Thiopental