Background: In adults anesthetized with propofol, muscle relaxants may decrease the Bispectral Index (BIS). The aim of this prospective randomized trial was to detect the influence of a muscle relaxant bolus on the BIS and the Cerebral State Index (CSI) in children under propofol anesthesia. Methods: Forty pediatric patients, age 6.6 ± 3.3 years, weight 24 ± 9 kg, scheduled for surgical procedures requiring general anesthesia were enrolled. Two minutes after i.v. injection of 0.3 mcg·kg-1of sufentanil, general anesthesia was induced by an initial bolus of 3 mg·kg-1of propofol, followed by a continuous infusion titrated to achieve a stable BIS value of 50 ± 5. Patients received either mivacurium 0.25 mg·kg-1(Group Miva) or NaCl 0.9% 0.12 ml·kg-1(Group Control). Mean BIS and CSI values per minute were compared between (Miva vs. Control) and within groups (Baseline vs 5 min. after study drug administration). Results: The observed changes in BIS and CSI values before and after administration of study drugs revealed no differences between the study groups. Mean baseline BIS and CSI values were lower than 5 min after study drug administration. There were no intergroup differences with respect to BIS and CSI values at any time point. Conclusions: These data suggest that in pediatric patients anesthetized with propofol, administration of mivacurium has no impact on BIS and CSI values.

bispectral index, cerebral state index, children, electroencephalogram, neuromuscular block, propofol,
Paediatric Anaesthesia
Erasmus MC: University Medical Center Rotterdam

Weber, F, Kriek, N, & Blussé van Oud-Alblas, H.J. (2010). The effects of mivacurium-induced neuromuscular block on Bispectral Index and Cerebral State Index in children under propofol anesthesia - A prospective randomized clinical trial. Paediatric Anaesthesia, 20(8), 697–703. doi:10.1111/j.1460-9592.2010.03327.x