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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 June;67(6):435-9

language: English

Bispectral index monitoring in sevoflurane and remifentanil anesthesia. Analysis of drugs management and immediate recovery

Paventi S., Santevecchi A., Metta E., Annetta M. G., Perilli V., Sollazzi L., Ranieri R.

From the Istituto di Anestesia e Rianimazione Università Cattolica del Sacro Cuore - Roma


Back­ground. ­Recent stud­ies ­have sug­gest­ed ­that elec­tro­en­ceph­a­lo­gram bispec­tral ­index (BIS) mon­i­tor­ing can ­improve recov­ery ­after anaesthe­sia and ­save mon­ey by short­en­ing ­patients post­op­er­a­tive ­stay. The aim of the ­study is to eval­u­ate the man­age­ment of ­drugs and to meas­ure imme­di­ate recov­ery ­after anaesthe­sia ­with or with­out BIS mon­i­tor­ing.
Meth­ods. We stud­ied 90 ­patients under­go­ing abdom­i­nal sur­gery ran­dom­ly allo­cat­ed to one of two ­groups of 45 ­each ­with or with­out BIS mon­i­tor­ing. Stan­dard mon­i­tor­ing (EKG, arte­ri­al oxy­gen sat­u­ra­tion and non-inva­sive ­blood pres­sure) was ­applied. All ­groups ­were mon­i­tored ­with BIS, ­using elec­trodes (Zip­prep, ­Aspect Med­i­cal ­Systems) ­applied to the fore­head. In the ­group 2 the BIS val­ue was blind­ed to the anaesthe­sio­lo­gist. The BIS val­ue was dis­played ­using Space­labs Med­i­cal BIS Ultra­view Mon­i­tor. ­After obtain­ing base­line val­ues for the BIS ­index (­group 1) and hae­mod­y­nam­ic ­data (all ­groups) anaesthe­sia was ­induced ­with a ­bolus ­dose of remi­fen­ta­nil and TPS, and vec­u­ro­ni­um. The anaesthe­sia was main­tained ­with Remi­fen­ta­nil and Sevof­lu­rane. At stan­dard ­times BIS, hae­mod­y­nam­ic and res­pir­a­to­ry param­e­ters ­were record­ed. Recov­ery ­times ­were meas­ured by a ­study coor­di­na­tor. ­Drug con­sump­tion was cal­cu­lat­ed.
­Results. In ­group 1 the con­sump­tion of Sevof­lu­rane ­decreased by 40% ­while the con­sump­tion of remi­fen­ta­nil ­decreased by 10%, as com­pared to ­group 2. The use of vec­u­ro­ni­um did not ­change in the 2 ­groups. In ­group 1 the ­time ­elapsed ­from ces­sa­tion of anaesthet­ics to orien­ta­tion ­decreased sig­nif­i­cant­ly. The dif­fer­ence was 5 min, ­from 11 to 6 min.
Con­clu­sions. BIS mon­i­tor­ing ­decrease ­both sevof­lu­rane and remi­fen­ta­nil con­sump­tion, ­when com­pared to anaesthe­sia with­out BIS, ­with an imme­di­ate recov­ery ­after sevof­lu­rane and remi­fen­ta­nil anaesthe­sia.

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