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Anesth Analg 2008; 106:670-
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318160fa24
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LETTER TO THE EDITOR

Section Editor:
Lawrence Saidman

Increased Anesthetic Depth, Not Metoprolol, May Have Caused the Change in Bispectral Index

Joana K. Panni, PhD, and Moeen K. Panni, MD, PhD

Department of Anesthesiology; University of Texas; Houston Medical School; Houston, TX; Moeen.K.Panni{at}uth.tmc.edu

To the Editor:

Sinha et al.1 describe a decrease in the Bispectral Index (BIS) following IV metoprolol. However, this reduction in the BIS also followed both IV administration of 50 mg of propofol and increasing the inhaled concentration of isoflurane to 3%, either of which may lead a the BIS decrease. Adrenergic drugs, such as metoprolol, may affect BIS levels as reported by Dr. Sinha and are likely related to central nervous system perfusion changes2; however, Sinha et al. report normal hemodynamics during the episode. Thus, we suggest that changes in anesthetic depth from the propofol and/or isoflurane are more likely than the metoprolol to have contributed to the change of the BIS.

REFERENCES

  1. Sinha PK, Jacob D, Koshy T. Rapid decrease in bispectral index following a single intravenous injection of metoprolol. Anesth Analg 2007;105:548–9[Free Full Text]
  2. Dahaba AA. Different conditions that could result in the bispectral index indicating an incorrect hypnotic state. Anesth Analg 2005;101:765–73[Abstract/Free Full Text]




This Article
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2008 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press