Intraoperative multiple intercostal nerve blocks exert anesthetic-sparing effect: A retrospective study on the effect-site concentration of propofol infusion in nonintubated thoracoscopic surgery

Less general anesthetic is required in patients with regional blocks than in those without, as assessed through commonly used anesthesia monitoring parameters such as blood pressure, heart rate, and bispectral index (BIS). Although intraoperative regional anesthesia has become more widely adopted, f...

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Bibliographic Details
Published in:Acta anaesthesiologica Taiwanica 2016-09, Vol.54 (3), p.77-80
Main Authors: Wang, Man-Ling, Hung, Ming-Hui, Chan, Kuang-Cheng, Chen, Jin-Shing, Cheng, Ya-Jung
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthetics, Intravenous - pharmacology
effect-site concentration
Electroencephalography
Female
Humans
intercostal nerve blockade
Intercostal Nerves
Intraoperative Care
Male
Middle Aged
Nerve Block
Propofol - pharmacology
Retrospective Studies
Thoracic Surgery, Video-Assisted
thoracoscopic
video-assisted thoracoscopic surgery
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Summary:Less general anesthetic is required in patients with regional blocks than in those without, as assessed through commonly used anesthesia monitoring parameters such as blood pressure, heart rate, and bispectral index (BIS). Although intraoperative regional anesthesia has become more widely adopted, few studies have confirmed or monitored its anesthetic-sparing effects. Using recent reports of nonintubated video-assisted thoracoscopic surgery (VATS) by BIS-targeted propofol infusion and intraoperative multilevel thoracoscopic intercostal nerve blocks (TINBs), this retrospective study investigated whether the anesthetic-sparing effect can be realized by reducing the effect-site concentration (Ce) to the targeted BIS level or by reducing the blood pressure at the onset of regional blocks. A retrospective study of a prospectively collected case series of non-intubated VATS. Data on 56 adult patients who underwent nonintubated VATS were collected and analyzed. The mean operative time was 121 ± 32 minutes. BIS levels before and after one-lung ventilation/TINBs and surgery were 48% ± 11% and 47% ± 12%, respectively. The Ce of propofol infusion decreased significantly from 3.4 ± 0.8 μg/mL to 3.0 ± 0.7 μg/mL (p 
ISSN:1875-4597
1875-452X
DOI:10.1016/j.aat.2016.07.001