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Anesthesia & Analgesia - Propofol, Ketamine and BIS

Date Published: 
November 2001

One wonders why Ibrahim, et. al.(1) cite two obscure journals(2,3) to support their contention that ketamine added to propofol significantly affected the accuracy of the bispectral (BIS) index (Aspect Medical Systems, Inc., Newton, MA) when two more readily accessible journals(4,5) refute that notion. Is there some anti-BIS bias lurking?

Barry L. Friedberg, M.D.
Clinical Instructor in Anesthesia
University of Southern California
Los Angeles, CA
Tel. 949-233-8845
FAX 949-760-9444
email drfriedberg@doctorfriedberg.com
web www.doctorfriedberg.com

References: 
  1. Ibrahim AE, Taarady JK, Kharasch ED. Bispectral index monitoring during sedation with sevoflurane, midazolam, and propofol. Anesthesiol 2001;95:1151-9.
  2. Suzuki M, Edmonds HL, Tseuda K, et. al. Effect of ketamine on bispectral index and levels of sedation. J Clin Monit Comput 1998;14:373.
  3. Sakai T, Singh H, Mi WD, et.al. The effect of ketamine on clinical endpoints of hypnosis and EEG variables during propofol infusion. Acta Anesthesiol Scand 1999;43:212-6.
  4. Aramov MN, Badrinath S, Shadrick M, et. al. The effect of ketamine on EEG-bispectral index during propofol sedation. Anesthesiol 1997;87:A501.
  5. Friedberg BL. The effect of a dissociative dose of ketamine on the bispectral index (BIS) during propofol hypnosis. J Clin Anes 1999;11:4-7.
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