Posologies des agents anesthésiques chez le centenaire ? Intérêt du monitorage par le BIS™

A 106-year-old female underwent emergency colectomy for peritonitis secondary to ischemic colitis. Following induction of anaesthesia with 18 mg etomidate (0,4 mg/kg), BIS™ monitoring allowed to perform surgery with an averaged desflurane end-tidal concentration and remifentanil infusion as low as 0.9% and 0.057 μg/kg/minute respectively. The mean BIS™ value was of 45 ±4 (min =38, max =50), systolic arterial pressure was maintained within ±10% of control values during 72% of anaesthesia duration (160 min) and the maximal drop did not exceed 27%. No adrenergic agent was used. This observation underlined the interest of BIS™ when anaesthetic requirement are difficult to estimate rapidly.