Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia
- PMID: 9357886
- DOI: 10.1097/00000542-199710000-00018
Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia
Abstract
Background: The bispectral (BIS) index has previously been shown to be a quantifiable measure of the sedative and hypnotic effects of anesthetic drugs. This study was designed to assess the effect of BIS monitoring on the utilization of volatile anesthetics and their recovery profiles after ambulatory surgery.
Methods: Sixty consenting women undergoing outpatient laparoscopic tubal ligation procedures were randomly assigned to one of four treatment groups. After a standardized induction, anesthesia was maintained with either desflurane (Groups I and II) or sevoflurane (Groups III and IV) in combination with nitrous oxide, 65%, and fentanyl. In the control groups (Groups I and III), the anesthesiologists were blinded to the BIS value, and the volatile anesthetics were administered according to standard clinical practice. In Groups II and IV, the volatile anesthetics were titrated to maintain the BIS value at 60. The volatile anesthetic usage and the times from discontinuation of anesthesia to verbal response, orientation, and home-readiness were recorded.
Results: During the maintenance period, the BIS values were significantly lower in the control groups (mean, 42) compared with the BIS-titrated groups (mean, 60). The volatile anesthetic usage in the BIS-titrated groups was 30-38% lower (P < 0.05) compared with the control groups. Similarly, the times to verbal responsiveness were 30-55% shorter in the BIS-titrated (vs. control) groups.
Conclusions: Titrating desflurane and sevoflurane using the BIS monitor decreased their utilization and contributed to a faster emergence from anesthesia in outpatients undergoing laparoscopic tubal ligation procedures.
Similar articles
-
Desflurane versus sevoflurane for maintenance of outpatient anesthesia: the effect on early versus late recovery and perioperative coughing.Anesth Analg. 2009 Aug;109(2):387-93. doi: 10.1213/ane.0b013e3181adc21a. Anesth Analg. 2009. PMID: 19608808 Clinical Trial.
-
Bispectral index monitoring does not improve early recovery of geriatric outpatients undergoing brief surgical procedures.Can J Anaesth. 2006 Jan;53(1):20-5. doi: 10.1007/BF03021523. Can J Anaesth. 2006. PMID: 16371605 Clinical Trial.
-
Does the use of electroencephalographic bispectral index or auditory evoked potential index monitoring facilitate recovery after desflurane anesthesia in the ambulatory setting?Anesthesiology. 2004 Apr;100(4):811-7. doi: 10.1097/00000542-200404000-00010. Anesthesiology. 2004. PMID: 15087615 Clinical Trial.
-
The effect of cerebral monitoring on recovery after general anesthesia: a comparison of the auditory evoked potential and bispectral index devices with standard clinical practice.Anesth Analg. 2003 Dec;97(6):1667-1674. doi: 10.1213/01.ANE.0000087041.63034.8C. Anesth Analg. 2003. PMID: 14633540 Clinical Trial.
-
Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane?Anesth Analg. 1998 Dec;87(6):1245-8. doi: 10.1097/00000539-199812000-00006. Anesth Analg. 1998. PMID: 9842806 Clinical Trial.
Cited by
-
Bibliometric Evaluation of the 100 Top-Cited Articles on Anesthesiology.Cureus. 2023 Dec 22;15(12):e50959. doi: 10.7759/cureus.50959. eCollection 2023 Dec. Cureus. 2023. PMID: 38249230 Free PMC article. Review.
-
[Processed EEG for personalized dosing of anesthetics during general anesthesia].Anaesthesiologie. 2023 Sep;72(9):662-676. doi: 10.1007/s00101-023-01313-0. Epub 2023 Aug 8. Anaesthesiologie. 2023. PMID: 37552241 Free PMC article. Review. German.
-
Frequency and characteristics of patients with bispectral index values of 60 or higher during the induction and maintenance of general anesthesia with remimazolam.Sci Rep. 2023 Jun 20;13(1):9992. doi: 10.1038/s41598-023-37150-9. Sci Rep. 2023. PMID: 37340043 Free PMC article.
-
Comparison of cerebral metabolic rate of oxygen, blood flow, and bispectral index under general anesthesia.Neurophotonics. 2023 Jan;10(1):015006. doi: 10.1117/1.NPh.10.1.015006. Epub 2023 Mar 6. Neurophotonics. 2023. PMID: 36911206 Free PMC article.
-
Effects of anesthetic depth on postoperative pain and delirium: a meta-analysis of randomized controlled trials with trial sequential analysis.Chin Med J (Engl). 2022 Dec 5;135(23):2805-2814. doi: 10.1097/CM9.0000000000002449. Chin Med J (Engl). 2022. PMID: 36728598 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous