The Effect of Aminophylline on Loss of Consciousness, Bispectral Index, Propofol Requirement, and Minimum Alveolar Concentration of Desflurane in Volunteers

Alparslan Turan; Yusuke Kasuya; Raghavendra Govinda; Detlef Obal; Stefan Rauch; Jarrod E. Dalton; Ozan Akca; Daniel I. Sessler

doi:10.1213/ANE.0b013e3181c6be7e

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The Effect of Aminophylline on Loss of Consciousness, Bispectral Index, Propofol Requirement, and Minimum Alveolar Concentration of Desflurane in Volunteers

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The Effect of Aminophylline on Loss of Consciousness, Bispectral Index, Propofol Requirement, and Minimum Alveolar Concentration of Desflurane in Volunteers

Alparslan Turan, Yusuke Kasuya, Raghavendra Govinda, Detlef Obal, Stefan Rauch, Jarrod E. Dalton, Ozan Akca and Daniel I. Sessler

Anesthesia and analgesia, Vol.110(2), pp.449-454

02/01/2010

DOI: 10.1213/ANE.0b013e3181c6be7e

PMID: 19955506

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Abstract

BACKGROUND: Adenosine is a soporific neuromodulator; aminophylline, which is clinically used as a bronchodilator, antagonizes the action of adenosine in the central nervous system. Thus, we tested the hypothesis that aminophylline delays loss of consciousness (LOC) and speeds recovery of consciousness (ROC) with propofol anesthesia, and that aminophylline increases the minimum alveolar concentration (MAC) of desflurane. METHODS: In this double-blind crossover study, volunteers were randomized to either aminophylline or saline on different days. Aminophylline 6 mg/kg was given. IV, followed by 1.5 mg . kg(-1) . h(-1) throughout the study day. After 1h of aminophylline or saline administration, propofol 200 mg was given at a rate of 20 mg/min. The bispectral index was continuously monitored, as were times to LOC and ROC. After recovery from propofol, general anesthesia was induced with sevoflurane and subsequently maintained with desflurane. The Dixon "up-anddown" method was used to determine MAC in each volunteer after repeated tetanic electrical stimulation. RESULTS: Eight volunteers completed both study days. Time to LOC was prolonged by aminophylline compared with saline (mean +/- SD) (7.7 +/- 2.03 min vs 5.1 +/- 0.75 s, respectively, P = 0.011). The total propofol dose at LOC was larger with aminophylline (2.2 +/- 0.9 vs 1.4 +/- 0.4 mg/kg, P = 0.01), and the time to ROC was shorter (6.18 +/- 3.96 vs 12.2 +/- 4.73 min, P = 0.035). The minimum bispectral index was greater with aminophylline (51 +/- 15 vs 38 9, P = 0.034). There was no difference in MAC. CONCLUSION: Aminophylline decreases the sedative effects of propofol but does not affect MAC of desflurane as determined by tetanic electrical stimulation. (Anesth Analg 2010;110:449-54)

Anesthesiology

Life Sciences & Biomedicine

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Title: Subtitle: The Effect of Aminophylline on Loss of Consciousness, Bispectral Index, Propofol Requirement, and Minimum Alveolar Concentration of Desflurane in Volunteers
Creators: Alparslan Turan - Cleveland Clinic
Yusuke Kasuya - Tokyo Womens Med Univ, Dept Anesthesiol, Tokyo, Japan
Raghavendra Govinda - Tufts Medical Center
Detlef Obal - University of Louisville
Stefan Rauch - University of Louisville
Jarrod E. Dalton - Cleveland Clinic
Ozan Akca - University of Louisville
Daniel I. Sessler - Cleveland Clinic
Resource Type: Journal article
Publication Details: Anesthesia and analgesia, Vol.110(2), pp.449-454
DOI: 10.1213/ANE.0b013e3181c6be7e
PMID: 19955506
NLM abbreviation: Anesth Analg
ISSN: 0003-2999
eISSN: 1526-7598
Publisher: Lippincott Williams & Wilkins
Number of pages: 6
Grant note: University of Louisville Cleveland Clinic
Language: English
Date published: 02/01/2010
Academic Unit: Anesthesia
Record Identifier: 9984696726502771

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