Intravenous General Anesthesia for Patients with Neurological Disorders

054 was initiated using the TCI method. The dose of propofol was titrated to achieve a BIS of 50 and achieve an adequate level of anesthesia: asleep but not responding to stimulation. Endotracheal intubation was not performed, and spontaneous breathing was maintained. The level of anesthesia was maintained at BIS 30-50 by adjusting the target propofol level using TCI (Figure 1). Without BIS, The dose of propofol was titrated to achieve a Mackenzie Grant score of 5 and to achieve an adequate level of anesthesia: asleep, but not responding to stimulation. The level of anesthesia was maintained at a Mackenzie and Grant score of 5 by adjusting the target propofol level using the propofol TCI (Figure 2). If respiratory depression was observed or BIS value was less than 30, the target blood concentration of propofol was decreased by 0.2 μg/ml. If the anesthesia level was deemed inadequate BIS value was more than 50, the target blood level of propofol was increased by 0.2 μg/ml. The dental procedure was started after the anesthesia level became stable without respiratory depression. A local anesthetic was used appropriately by the operating dentist. Administration of propofol was discontinued at the end of the dental procedure. Patients were monitored until recovery from anesthesia, when they were fully awake and had stable respiration.