The BIS values (25, 50, and 75 percentile)

at the predetermined time points are presented as a Box Plot (figure 2). Table 2 Number and percentage of the patients with a bispectral index above 60 Discussion In spite of the remarkable trend toward the use of regional anesthesia in Western Europe and USA, many C/S patients still undergo the operation under general anesthesia elsewhere in the world.13-16 Some of these patients are frightened of the prospect of a needle in their back or wakefulness during major abdominal surgery.16 Regional anesthesia is liable to be very problematic, unfeasible, or contraindicated Inhibitors,research,lifescience,medical in some other patients with special medical problems.17-25 The rates of awareness and occurrence of unpleasant dreams during general anesthesia for C/S in

different studies have been reported between 0.13-7% and 17%, respectively. These figures are Inhibitors,research,lifescience,medical clearly higher in other cases, probably leading to severe psychological sequelae.26,27 The use of clinical signs is not Inhibitors,research,lifescience,medical of much help to the anesthetist in precisely assessing the level of hypnosis through general anesthesia. However, the use of relevant variables such as unresponsiveness, HR, BP, and the anesthetic method has proven WEEL inhibitors library useful enough to explain the causes of awareness.28,29 Clinical signs to infer the depth of anesthesia, which rely on changes in the autonomic nervous system, are obscured by concurrent drugs such as adrenergic blockers, coexisting diseases such as hypertension, and side effects of agents given during surgery such as tachycardia associated with isoflurane. Moreover, hypovolemia, hypoxia, hypercapnia, or inadequate analgesia rather Inhibitors,research,lifescience,medical than inadequate anesthesia may lead to

such manifestations. Because many purposeful movements are due to reflexes at the level of the spinal cord, they cannot essentially denote that the patient is awake.30 BIS monitoring provides Inhibitors,research,lifescience,medical an EEG–derivative index, a numerical array from 1 to 100 that has been reported to correlate with Tolmetin the central nervous system (CNS)-depressant effects of anesthetic drugs. This monitoring tool is sensitive to the hypnotic effects of inhaled anesthetics as well as Propofol in a dose-dependent manner. It is also deserving of note that the BIS is not sensitive enough for the assessment of analgesia and evaluation of the effect of opioids during general anesthesia.19,31-33 Sodium thiopental requirement is decreased during pregnancy.34 The present study was started with 4 mg/kg Sodium Thiopental, but the administration of this dose to the second patient was accompanied by aggressive movements of all the extremities and severe bucking with intubation. Therefore, 5 mg/kg of Sodium Thiopental was preferred for the remaining 58 patients afterward.