BACKGROUND:Intraoperative awareness is a frightening experience for any patient for it has long term psychological consequences. Among the various tools available for monitoring depth of anaesthesia, Bispectral index monitoring (BIS) is one of the recent and widely accepted techniques. AIMS AND OBJECTIVES: The present study was carried out to evaluate and correlate the efficacy of BIS monitoring along with PRST score in assessment of depth of anaesthesia. MATERIALS AND METHODS: A prospective clinical study was conducted on 160 patients undergoing surgery in various specialties, in the department of Anaesthesiology at Rajarajeswari Medical College and Hospital which included adult patients between the ages of 18 and 65 years and of ASA I/II posted for elective surgeries under general anaesthesia. Conditions and drugs likely to interfere with BIS values were excluded. Anaesthesia protocol was kept uniform. These patients were divided into two groups of 80 patients each by consecutive selection. In Group 1-depth of anaesthesia was assessed by PRST score, in Group 2-by BIS monitoring and PRST score. Statistical analysis was performed by descriptive statistics to calculate the mean and standard deviation, the t-test, χ² tests for calculating the materiality for establishing the results. RESULTS: We saw that the Bispectral index varied with various stages of anaesthesia, almost simultaneous changes in systolic, diastolic and mean arterial blood pressures occurred in both groups in T1 and T2. On intubation, both blood pressure and heart rate increased but BIS showed a very minimal increase, which was because of adequate depth of anaesthesia and analgesia. There was a statistically significant difference in PRST scores between the two groups. There was no incidence of awareness among our study population. CONCLUSION: Evaluation of intraoperative depth of anaesthesia is one of the major tasks of anaesthesiologist. In patients with higher operative risk, using clinical parameters along with BIS monitor allows us to make precise decision and balance the dose of anaesthetics and cardioactive agents.
BACKGROUNDAmong the various methods of treating the long bone fractures in children less than 5yrs (POP cast) and adolescents 16yrs (IMN), flexible intramedullary nail has gained importance because of its stability, not violating the physis and less complications and early rehabilitation. Irrespective of mode of treatment, goal shall be to achieve union at fracture site, control length and alignment, minimize the morbidity and complications for patient and their family.
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