Abstract
Background: The auditory evoked potential (AEP) index and bispectral (BIS) index have been proposed as methods to measure the depth of sedation. A prospective study was designed to assess the performance of both these methods for measuring the depth of sedation induced by propofol patient-controlled sedation (PCS) under spinal anesthesia. Methods: Forty ASA I and II adult patients under spinal anesthesia using 0.5% hyperbaric bupivacaine were studied. Group 1 (10mg bolus, 30 mg loading) and Group 2 (20 mg bolus, 60 mg loading) received propofol and maintained PCS with 1min lockout interval and 100 mg/hr continuous infusion. AEP, BIS and Observer's assessment of alertness/sedation (OAA/S) scale were monitored during the operation. Results: AEP and BIS decreased and increased following the changes on the patient's OAA/S scores and correlated with sedation significantly. There were no significant difference in mean AEP index (group 1; 13.4 8.4, group 2; 8.9 6.2), BIS index (group 1; 76.2 9.7, group 2; 71.2 9.8), and OAA/S scale (group 1; 3.8 1.3, group 2; 3.2 1.5) between the groups. Incidence of perioperative respiratory depression was significantly higher in group 2 (25%) than group 1 (5%), and incidence of involuntary movement was significantly higher in group 1 (20%) than group 2 (5%) (P
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