Hydrocephalus Clinical Trial
Official title:
Bispectral Index Monitoring of Propofol Anesthesia in Patients With Hydrocephalus. A Prospective Observational Study
We tested the hypothesis that BIS values are altered in pediatric patients with hydrocephaly. We also tested the hypothesis that BIS values are altered in adult post cerebral hemorrhage patients with hydrocephaly undergoing ventricular-peritoneal shunt placement
Context: Enlarged skull circumference in patients with hydrocephalus might alter bispectral
index (BIS) values; as distorted skull contour distances sensors from a shifted cerebral mass
as well as mental dysfunction as a result of disrupted Cerebrospinal fluid circulation.
Objectives: Investigators tested the hypothesis that BIS values are altered in pediatric
patients with hydrocephaly. Investigators also tested the hypothesis that BIS values are
altered in adult post cerebral hemorrhage patients with hydrocephaly undergoing
ventricular-peritoneal shunt placement.
Methods: After ethics committee approval participants, or their next of kin, who gave written
informed consent were recruited in the study. Investigators excluded potential participants
suffering from hepatic disease. In the first study 15 pediatric patients with hydrocephaly
and 15 pediatric control patients at approximately the same age group were included in the
study.
In the second study 15 post cerebral hemorrhage adult patients undergoing
ventricular-peritoneal shunt placements and 15 adult control patients were included in the
study.
2 BIS sensors were placed on patients' forehead and connected to BIS-Vista monitors. In a
quiet anesthesia induction room investigators recorded BIS-Vista for 10 min before induction.
Remifentanil 4 ng ml-1 was started and propofol TCI was kept constant at 4 microg ml-1 with
no adjustments for a 1 h anesthesia maintenance study-recording period when time of surgery
allowed. Investigators also noted BIS values immediately before and after a patent
ventricular-peritoneal shunt was successfully installed. After conclusion of surgical
procedures, remifentanil and propofol infusions were terminated and this marked the beginning
of the recovery phase of the study where we recorded BIS values for another 20 min emergence
from anesthesia.
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