Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.3.1.177 (BIS)
 957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The transcutaneous PO2 (tcPO2) response to blood interruption (BIS test) was measured in 6 healthy adults and 28 infants, including premature infants. The response was similar in both infants and adults with a time lag at the beginning of blood interruption, a subsequent linear decrease, a time lag at the end of blood interruption, and an exponential recovery to the final steady state. The linear decrease of tcPO2 in the BIS test had a correlation coefficient of more than 0.98 in all subjects and indicated the cutaneous oxygen consumption rate independent of the oxygen pressure. There was a significant difference in oxygen consumption according to birth weight in the infants (< 2 kg, 2-3 kg, and > 3 kg). The recovery time constant for infants was 13 seconds which was about 1.4 times faster than that for adults, and it increased significantly along with a higher birth weight. The time lag at blood interruption was longer than that at blood recovery. The time lag for infants was significantly shorter than that for adults, and in infants there was a significant difference between the group with a birth weight < 2 kg and the others (p < 0.005). All of the parameters of the BIS test suggested the physiological immaturity of premature infants.
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PMID:Analysis of the tcPO2 response to blood interruption in infants and adults. 147 20

The development of a simple method for rapid screening of antioxidants in the preformulation phase of drug development is reported. Using an easily oxidizable drug substance containing a tetrahydroisoquinoline nucleus, the relative antioxidant efficacies was determined by simultaneous measurement of dissolved oxygen depletion and drug disappearance rates in presence and absence of antioxidants by oxygen polarographic and high performance liquid chromatographic (HPLC) methods, respectively. Results showed an inverse correlation between oxygen depletion and drug disappearance rates (R2 > 0.85). In contrast, such a high correlation was not obtained when the standard redox potential of these antioxidants was used as a predictor of drug disappearance rates (R2 > 0.50). The rate at which sodium metabisulfite (BIS) and glutathione depleted dissolved oxygen was reduced in the presence of drug, indicating possible reaction between either of the two antioxidants and drug (OHM-11252). Hence, BIS and glutathione may not be suitable antioxidants for stabilizing OHM-11252 in solution. The oxygen depletion rate constants and percent of intact drug remaining were higher in presence of ascorbic acid (ASC) than BIS. Analysis of the reaction mixtures by HPLC diode array detection showed that the number and percent peak area of non-drug peaks formed from ASC-stabilized drug were lower than for BIS. Hence, ASC provides the drug better protection from oxidative degradation.
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PMID:Systematic screening of antioxidants for maximum protection against oxidation: an oxygen polarograph study. 1075 21

A 62-year-old woman (148 cm, 48.5 kg) with a history of bronchial asthma underwent an emergency appendectomy. Ten days before the operation she developed symptoms of wheezing while under asthma medication. An endotracheal tube (7 mm) was inserted after the induction of general anesthesia with intravenous injection of fentanyl 100 micrograms, propofol 100 mg and vecuronium 10 mg under Sellick's maneuver. Anesthesia was maintained with 1% sevoflurane with oxygen 6l-min-1 just after intubation, but bilateral lung sound soon became weaker and ventilation difficult. Based on a diagnosis of bronchoconstriction, we started hyperventilation with 3% sevoflurane. Ventilation returned to normal after about 5 minutes. Percutaneous O2 saturation was maintained at 100% during this episode, but the BIS transiently rose to 82. Anesthesia was maintained with 2% sevoflurane and 50% nitrous oxide balanced with oxygen, and 250 mg aminophylline was administered. Upon completion of the operation, the endotracheal tube was removed without any events. The patient gave no sign of awareness during the operation. When severe bronchoconstriction prevents the absorption of anesthetics from the lung alveoli, additional intravenous anesthetics should be administered to maintain stable amnesia.
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PMID:[Transient increase of bispectral index in a patient with bronchoconstriction after endotracheal intubation]. 1496 9

Deep hypothermic circulatory arrest (DHCA) is usually a planned approach to certain types of cardiovascular surgery. This case report is an example of DHCA used to provide cerebral protection for a patient whose right ventricle was lacerated by an oscillating saw during sternotomy. The surgical case was a redo coronary artery bypass graft surgery. Anesthetic intervention with specific drug administration and steps taken for neuroprotection are discussed. Before DHCA, anesthetic interventions are used to reduce brain metabolism and, thus, oxygen consumption for the 30- to 60-minute window of complete circulatory arrest. Although not having an electroencephalographic monitor for the case, an interesting finding was that the bispectral monitor (or BIS monitor) was at the zero level for the entire circulatory arrest and about 30 minutes after rewarming.
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PMID:Use of deep hypothermic circulatory arrest following ventricular laceration: a case report. 1520 66

The growing interest in combining local and general anesthesia has led to studies investigating possible interactions between general anesthesia and local anesthetics administered via spinal, epidural, IV, or IM routes. However, no study has evaluated the effect of local anesthetics on all three components of balanced anesthesia, i.e., hypnosis, analgesia, and muscle relaxation. In this prospective, randomized, double-blind study, we investigated the effect of epidural bupivacaine on the dose requirement of propofol (as evaluated by using the bispectral index [BIS]), fentanyl, and vecuronium for general anesthesia. This study consisted of 30 adults, ASA physical status I and II, undergoing Whipple's pancreaticoduodenectomy for periampullary carcinoma lasting >4 h. An epidural catheter was placed between T9-10. Depending on the group allocation, 10 mL of the study drug was administered as a bolus followed by an infusion at 6 mL/h via the epidural catheter. Patients were divided into 2 groups of 15 each. Patients in the control group received epidural normal saline whereas those in the bupivacaine group received epidural bupivacaine 0.1%. Induction of anesthesia was performed with IV fentanyl 2 mug/kg and propofol titrated to achieve BIS between 40-50. Endotracheal intubation was facilitated by the IV administration of vecuronium 0.1 mg/kg and patient's lungs were ventilated with 66% nitrous oxide in oxygen. After intubation, infusion of propofol 1% was titrated to maintain BIS between 40-50. Inadequate analgesia was defined as an increase in systolic blood pressure and/or heart rate by >20% of baseline values in response to surgical stimulus and was treated with bolus fentanyl 0.5 mug/kg. Neuromuscular monitoring was used to assess the need for additional doses of vecuronium. Data were analyzed by using the Student's t-test and P </= 0.05 was considered significant. The requirement of propofol for induction and maintenance of anesthesia in the bupivacaine group was 1.3 +/- 0.3 mg/kg and 2.4 +/- 0.9 mg . kg(-1) . h(-1), respectively, compared with 2.4 +/- 0.6 mg/kg and 4.4 +/- 1.6 mg . kg(-1) . h(-1) observed in the control group (P < 0.05). Significant reduction was also observed in the requirement of vecuronium and fentanyl during maintenance in the bupivacaine group (P < 0.05). We conclude that epidural bupivacaine given before induction of anesthesia reduces the requirement of propofol, fentanyl, and vecuronium during general anesthesia.
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PMID:The effect of epidural bupivacaine on induction and maintenance doses of propofol (evaluated by bispectral index) and maintenance doses of fentanyl and vecuronium. 1611 22

Anesthetic management of super-obese patients is inferred from evidence which has been based on obese or morbidly obese patients. We present the perioperative management and monitoring of a 44-year-old 232-kg patient (BMI 70) admitted for laparoscopic gastric bypass surgery. Awake fiberoptic endotracheal intubation preceded induction with propofol and rocuronium. Anesthesia was maintained with desflurane and remifentanil. Desflurane was titrated on BIS values, whereas remifentanil was based on hemodynamic monitoring (invasive arterial pressure and HemoSonic). Rocuronium was administered based on ideal body weight and recovery of twitch tension. Safe and rapid extubation in the operating theatre was made possible by the use of short-acting agents coupled with continuous intraoperative monitoring. Recovery in the post-anesthesia care unit was uneventful, pain was managed with meperidine, and after 5 hours the patient was discharged to the surgical ward. Oxygen therapy and SpO2 monitoring were continued overnight. No desaturation episodes were recorded. Pain was managed with I.V. drip of ketorolac and tramadole.
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PMID:Perioperative management and monitoring of a super-obese patient. 1560 65

We have investigated the relationship between structure and antioxidative activity of piperidine nitroxides which were substituted by different groups at the 4-position. All of the tested piperidine nitroxides inhibited malondialdehyde (MDA) generation caused either spontaneously or by a hydroxyl free radical generation system (Fe2+-ascorbic acid) in homogenates of liver, heart and kidney of rats, and antagonized H2O2-induced haemolysis from rat erythrocytes in a concentration-dependent manner. The same rank was followed: Bis-(4-amino-2,2,6,6-tetramethyl piperidinooxyl) (4-BIS-Tempo) and 4-azido-2,2,6,6-tetramethyl piperidinooxyl (4-N(3)-Tempo) > 4-isothiocyanate-2,2,6,6-tetramethyl piperidinooxyl (4-ISO-Tempo), 4-2', 4'-dinitrophenylhy-drazone-2,2,6,6-tetramethyl piperidinooxyl (4-D-Tempo), 4-sulfonate-2,2,6,6-tetramethyl piperidinooxyl (4-S-Tempo) and 4-amino-2,2,6,6-tetramethyl piperidinooxyl (4-NH(2)-Tempo) > 4-acetate ester-2,2,6,6-tetramethyl piperidinooxyl (4-A-Tempo) and 4-benzoate-2,2,6,6-tetramethyl piperidinooxyl (4-B-Tempo). With the exception of 4-A-Tempo and 4-D-Tempo, the tested piperidine nitroxides inhibited superoxide anion (O(2*-)) release from neutrophils stimulated by zymosan. The concentration required for inhibiting O(2*-) release was higher than that of inhibiting MDA formation and haemolysis. However, 4-amino-2,2,6,6-tetramethyl piperidine (4-NH2-TempH) and other 4-position substitutes, such as NaN3 and isothiocyanate, had no effects on MDA formation, haemolysis or O(2*-) release. The results indicated that nitroxides have a wide range of scavenging reactive oxygen species (ROS) actions. The nitroxide moiety was the essential group while the 4-position substitutes could influence the activity of nitroxides on scavenging ROS.
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PMID:The relationship between structure and antioxidative activity of piperidine nitroxides. 1680 54

A 41-year-old man (169 cm, 48 kg), having a 10 year history of Huntington disease, was presented for percutaneous endoscopic gastrostomy because of repeated aspiration episodes. He had suffered from choreiform movements, misswallowing and progressive mental deterioration. Midazolam 2 mg i.v. was given on transferring the patient to the operating room. On arriving, the patient was somnolent but responded to call. BIS index was 55. Anesthesia was induced with thiopental 120 mg i.v. and fentanyl 100 microg i.v. followed by vecuronium 4 mg i.v. After tracheal intubation, anesthesia was maintained with sevoflurane 1.5% in 33% oxygen. Bispectral index and train of four ratio were monitored throughout the anesthesia. BIS index and TOF ratios were proper for the drug dose used. At the end of the procedure, neuromuscular blockade was antagonized with neostigmine 2.0 mg and atropine 1.0 mg i.v. with no worsening of symptoms. The duration of anesthesia was 85 minutes. The patient woke up (BIS index 78) and spontaneous respiration returned and he was extubated. The postoperative course was uneventful. In this case, BIS index was abnormally low before induction of anesthesia as well as after anesthesia. Whether Huntington disease is responsible for the abnormally low bispectral index remains uncertain. But, anesthesiologists should be aware of this phenomenon to avoid an inappropriate adjustment of the anesthetic depth.
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PMID:[Anesthetic management for a patient with Huntington disease]. 1802 8

The aim of the present study was to compare the perioperative hemodynamics, propofol consumption and recovery profiles of remifentanil and dexmedetomidine when used with air-oxygen and propofol, in order to evaluate a postoperative analgesia strategy and explore undesirable side-effects (nausea, vomiting, shivering). In a prospective randomized double-blind study 50 ASAI-III patients scheduled for supratentorial craniotomy, were allocated into two equal Groups. Group D patients (n = 25), received i.v. dexmedetomidine 1 microg kg(-1) as preinduction over a 15-min period and 0.2-1 microg kg(-1) hr(-1) by continuous i.v. infusion during the operation period. Group R patients (n = 25), received remifentanil 1 microg kg(-1) as induction i.v. over a 15-min period and 0.05-1 microg kg(-1) min(-1) as maintenance. The propofol infusion was started at a rate of 10 mg kg(-1) h(-1) and titrated to maintain BIS in the range 40-50. Propofol doses for induction and maintenance of anesthesia was lower with dexmedetomidine (respectively p < 0.05, p < 0.01). The time for BIS to reach 50 was significantly shorter in Group D (p < 0.01). Comparison of the parameters of recovery revealed; extubation time (p < 0.01); response to verbal commands (p < 0.05) and time for orientation (p < 0.05) were longer with Group D. With respect to Post Anesthesia Care Unit (PACU) discharge time, dexmedetomidine patients required longer time when compared to remifentanil patients to achieve their first normal neurological score (33 min vs 31 min). The earliest opioid administration was at 38 min. in the dexmedetomidine group and 33 min. in the remifentanil group. Propofol-remifentanil and propofol-dexmedetomidine are both suitable for elective supratentorial craniotomy and provide similar intraoperative hemodynamic responses and postoperative adverse events. Propofol-remifentanil allows earlier cognitive recovery; however, it leads to earlier demand for postoperative analgesics. Undesirable side-effects were similar in two Groups.
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PMID:Remifentanil-propofol vs dexmedetomidine-propofol--anesthesia for supratentorial craniotomy. 1926 28

A 64-year-old woman (151 cm, 43 kg) with well controlled hypertension was diagnosed as having right lung cancer at S8 segment. She underwent right S8 segmentectomy by video assisted thoracic surgery (VATS) under general anesthesia combined with epidural anesthesia. Her vital signs were stable and BIS value was around 45 before the surgeon injected the air using a syringe with a 22 G needle to confirm the lesion resected. After the injection of air, her systolic blood pressure rapidly increased from 120 to 170 mmHg and the BIS value suddenly decreased to 5. Blood propofol concentration was reduced from 3 microg x ml(-1) to 2 microg x ml(-1) in the target-controlled infusion technique, and thereby the BIS value increased slowly. She did not wake up nor maintain sufficient spontaneous breathing even 2 hours after the discontinuation of opioids, and was transferred to ICU with tracheal intubation. In ICU, she showed clonic convulsions. Urgent CT and MRI confirmed cerebral air embolism. Her vital signs were too unstable to choose hyperbaric oxygen therapy as her first treatment. Her consciousness was recovered and her trachea was extubated on 11th postoperative day. She was discharged with left hemiparalysis from hospital.
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PMID:[Multiple cerebral infarction by air embolism associated with remarkable low BIS value during lung segmentectomy with video assisted thoracic surgery (VATS) technique: a case report]. 2042 Jan 39


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