[Changes of arterial blood pressure and heart rate during induction of anesthesia with propofol--efficacy of propofol titration using bispectral index as an indicator].

Bispectral index (BIS) is a processed EEG parameter that measures the hypnotic effects of anesthetic and sedative agents on the brain. We studied whether propofol titration using BIS allows us to prevent hemodynamic changes during induction of anesthesia and endotracheal intubation. Thirty patients without hypertension and obesity were studied. In the titration group (n = 15), BIS was maintained at 40 during induction of anesthesia with propofol. In the bolus group, anesthesia was induced with a bolus infusion of propofol 2 mg.kg-1 (n = 15). Arterial blood pressure and heart rate were recorded before induction of anesthesia, during induction of anesthesia, immediately after, and 1 min, 2 min, and 3 min after intubation. Diastolic blood pressure and heart rate increased significantly after endotracheal intubation in both groups. Systolic blood pressure significantly increased immediately after intubation in the bolus group, but was unchanged in the titration group. These results suggest that BIS is useful to prevent significant increases in systolic blood pressure associated with endotracheal intubation during induction of anesthesia with propofol.