The effect of intravenous epinephrine on the bispectral index and sedation

Eight patients were given a propofol infusion until they no longer responde d to loud verbal stimuli, a sedation score of two (modified Observer Assess ment of Alertness and Sedation Scale). After receiving 15 mu g of intraveno us epinephrine, changes in sedation score and bispectral index (BIS) were o bserved. Mean pulse rate increased front 68 to 96 (SD 10) beat.min(-1), mea n blood pressure increased from 107/60 (SD 10/8) mmHg to 140/70 (SD 27/14) mmHg, and mean BIS level rose from 63 to 76 (p < 0.005). Sedation scores in creased in six of the eight patients. Exogenous catecholamines seem to have an arousal effect oil lightly anaesthetised patients. This could be due to changes in neurotransmitter levels in the brain, or due to the effects con sequent on increased cardiac output.