28 September 2012
Correlation Between Bispectral Index, Observational Sedation Scale, and Lower Esophageal Sphincter Pressure in Volunteers Using Dexmedetomidine or Propofol
Alparslan TuranABDEF, Jarrod E. DaltonCD, Yusuke KasuyaBF, Ozan AkçaABE, Daniel I. SesslerDE, Stefan RauchABDEFDOI: 10.12659/MSM.883484
Med Sci Monit 2012; 18(10): CR593-596
Abstract
BACKGROUND: Many anesthetics reduce lower esophageal sphincter pressure (LESP) and consequently the gastroesophageal pressure gradient (GEPG); thus they may promote gastro-esophageal reflux and contribute to aspiration pneumonia. Our goals were to evaluate the association between LESP and 2 measures of sedation: bispectral index (BIS) and the responsiveness component of the Observer’s Assessment of Alertness score (OAA/S).
MATERIAL AND METHODS: Eleven healthy volunteers were each sedated on 2 separate days. Subjects were given sedative infusions of increasing target plasma concentrations of dexmedetomidine or propofol. LESP and GEPG were recorded after starting each infusion phase. Generalized estimating equation modeling was used to assess the relationship between LESP and, respectively, BIS and OAA/S. The existence of a drug-dependent association was evaluated within these models by testing an interaction term. Wald tests were used to evaluate the relationships within the models.
RESULTS: We found a significant relationship between LESP and BIS (P=0.0043) after adjusting for the main effect of sedative type – a deepening of sedation as measured by a decrease in BIS of 10% was associated with a decrease [Bonferroni-adjusted 95% CI] in LESP of –1.34 [–2.39, –0.29] mmHg. After adjusting for the main effect of sedative drug, LESP significantly declined with declining OAA/S (P=0.001); a unit decrease of OAA/S was associated with a decrease [Bonferroni-adjusted 95% CI] in LESP of –2.01 [–3.20, –0.81] mmHg.
CONCLUSIONS: Deeper sedation, as measured by either BIS or OAA/S, significantly reduces LESP.
Keywords: Hypnotics and Sedatives - pharmacology, Pressure, Esophageal Sphincter, Lower - physiology, Dexmedetomidine - pharmacology, Consciousness Monitors, Conscious Sedation, Propofol - pharmacology, young adult
Editorial
01 April 2023 : Editorial
Editorial: Effective Direct-Acting Antiviral Treatments Support Global and National Programs to Eliminate Hepatitis CDOI: 10.12659/MSM.940519
Med Sci Monit 2023; 29:e940519
SARS-CoV-2/COVID-19
30 March 2023 : Clinical Research
An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of M...Med Sci Monit In Press; DOI: 10.12659/MSM.939485
09 February 2023 : Clinical Research
Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...Med Sci Monit 2023; 29:e938892
19 January 2023 : Clinical Research
Determining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical Research
Effect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...Med Sci Monit 2022; 28:e938926
In Press
30 Mar 2023 : Clinical Research
An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of M...Med Sci Monit In Press; DOI: 10.12659/MSM.939485
30 Mar 2023 : Database Analysis
Global Research Trends and Hotspots in Lateral Epicondylitis During the Past 30 Years: A Bibliometric and V...Med Sci Monit In Press; DOI: 10.12659/MSM.939309
29 Mar 2023 : Laboratory Research
Preparation, Physicochemical Properties, and Structural Characterization of Resistant Starch-Aspirin-Loaded...Med Sci Monit In Press; DOI: 10.12659/MSM.939711
29 Mar 2023 : Database Analysis
Causes of Death in Neonates, Infants, Children, and Adolescents at the University Children’s Clinical Hospi...Med Sci Monit In Press; DOI: 10.12659/MSM.939915
Most Viewed Current Articles
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952