Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 142 No. 4142 (2012)

Effect of bispectral index monitoring on extubation time and analgesic consumption in abdominal surgery: a randomised clinical trial

  • Jasminka Persec
  • Zoran Persec
  • Mario Kopljar
  • Natasa Sojcic
  • Ino Husedzinovic
DOI
https://doi.org/10.4414/smw.2012.13689
Cite this as:
Swiss Med Wkly. 2012;142:w13689
Published
07.10.2012

Summary

PRINCIPLES: The aim of this study was to investigate the effect of bispectral index (BIS) monitoring on intra-operative anaesthesia consumption and extubation time. Design: Randomised controlled study.

METHODS: The study included 45 patients undergoing major abdominal surgery under general anaesthesia in a six month period (February – July 2011), aged 18 years or older, and classified as ASA (American Society of Anaesthesiologists) physical status II or III. Patients were randomly assigned to receive BIS-guided anaesthesia or routine anaesthesia care as a non BIS-guided group. At the induction of anaesthesia, and during the operation the following parameters were continuously recorded: BIS level, heart rate (HR), systolic blood pressure (sBP), end-tidal CO2 (etCO2).Operation time and time to extubation were also recorded. On the first post-operative day all patients were visited and interviewed about intra-operative recall.

RESULTS: BIS levels in the non BIS-guided group were significantly lower from 30 minutes further to the end of the operation, compared to the BIS-guided group (p <0.05). Time to extubation was significantly shorter in the BIS-guided group (17.5 min vs. 75 min, p <0.001). There were no statistically significant differences in the required amounts of anaesthetics. In the post-operative interview, none of the patients reported an episode of intra-operative awareness.

CONCLUSION: Guiding anaesthesia according to BIS level will result in significantly faster recovery after anaesthesia. The investigation was registered on ClinicalTrials.gov (NCT01470898).

References

  1. Kotsovolis G, Komninos G. Awareness during anesthesia: how sure can we be that the patient is sleep indeed? Hippokratia. 2001;13(2):83–9.
  2. Ghoneim MM. Awareness during anesthesia. Anesthesiology. 2000;92(2):597–602.
  3. Tempe DK. In search of a reliable awareness monitor. Anesth Analg. 2001;92(4):801–4.
  4. Monk T, Saini V, Weldon BC, Sigl JC. Anesthetic management and one-year mortality after noncardiac surgery. Anesth Analg. 2005;100(1):4–10.
  5. Green D, Paklet L. Latest development in peri-operative monitoring of the high-risk major surgery patient. International Journal of Surgery. 2010;8(2):90–9.
  6. Akcali DT, Özköse Z, Yardim S. Do we need bispectral index monitoring during total intravenous anesthesia for lumbar discectomies? Turkish Neurosurgery. 2008;18(2):125–33.
  7. Bonhomme V, Plourde G, Meuret P, Fiset P, Backman SB. Auditory steady-state response and bispectral index for assessing level of consciousness during propofol sedation and hypnosis. Anesth Analg. 2000;91(6):1398–403.
  8. Burrow N, Bigat Z, Akyuz M, Demir S, Ertok E. Does using the bispectral index (BIS) during craniotomy affect the quality of recovery? J Neurosurg Anesthesiol. 2006;18(1):1–4.
  9. Kissin I. Depth of anesthesia and bispectral index monitoring. Anesth Analg. 2000;90(5):1114–7.
  10. Gan TJ, Glass PS, Windsor A, Payne F, Rosow C, Sebel P, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology. 1997;87(4):808–15.
  11. Pavlin DJ, Hong JY, Freund PR, Koerschgen ME, Bower JO, Bowdle TA. The effect of bispectral index monitoring on end-tidal gas concentration and recovery duration after outpatient anesthesia. Anesth Analg. 2001;93(3):613–9.
  12. Johansen JW, Sebel PS, Sigl JC. Clinical impact of hypnotic-titration guidelines based on EEG bispectral index (BIS) monitoring during routine anesthetic care. J Clin Anesth. 2000;12(6):433–43.
  13. Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology. 1997;87(4):842–8.
  14. Liu SS. Effects of bispectral index monitoring on ambulatory anesthesia: a meta-analysis of randomized controlled trials and a cost analysis. Anesthesiology. 2004;101(2):311–5.
  15. Lindholm ML, Brudin L, Sandin RH. Bispectral index monitoring: appreciated but does not affect drug dosing and hypnotic levels. Acta Anaesthesiol Scand. 2008;52(1):88–94.
  16. Pavlin JD, Souter KJ, Hong JY, Freund PR, Bowdle TA, Bower JO. Effects of bispectral index monitoring on recovery from surgical anesthesia in 1,580 inpatients from an academic medical center. Anesthesiology. 2005;102(3):566–73.
  17. Klopman MA, Sebel PS. Cost-effectiveness of bispectral index monitoring. Curr Opin Anesthesiol. 2011;24(2):177–81.
  18. Punjasawadwong Y, Boonjeungmonkol N, Phongchiewboon A. Bispectral index for improving anaesthetic delivery and postoperative recovery. Cochrane Database Syst Rev. 2007;(4):CD003843.