Bispectral index for improving anaesthetic delivery and postoperative recovery

Abstract

BIS-guided anaesthesia can reduce the risk of intraoperative awareness in surgical patients at high risk for awareness in comparison to using clinical signs as a guide for anaesthetic depth. BIS-guided anaesthesia and ETAG-guided anaesthesia may be equivalent in protection against intraoperative awareness but the evidence for this is inconclusive. In addition, anaesthesia guided by BIS kept within the recommended range improves anaesthetic delivery and postoperative recovery from relatively deep anaesthesia.

The Clinical Effectiveness of the Bispectral Index (BIS) To Reduce the Risk of Awareness for Elective Surgical Patients Undergoing General Anesthesia: A Prospective, Randomized, Double-Blind, Controlled Trial

“…This result is consistent with the study of Punjasawadwong et al and Recart et al, which showed that BIS monitoring was associated with shortened duration in the PACU [44,48].…”

“…We also found a statistically significant reduction in end-tidal sevoflurane concentration when using BIS monitoring as compared with routine care and anesthesia monitoring protocols. Our results are in agreement with studies by Punjasawadwong, et al who showed that BIS-guided anesthesia can significantly reduce anesthetic consumption [24] and with Croci et al who showed that BIS monitoring in women undergoing general anesthesia for gynecological laparascopic surgery reduced desflurane consumption by 34.6% [32].Our study shows that the consumption of inhaled anesthesia was significantly less in the BIS group compared to the RC group. These results confirm that using BIS monitoring reduces consumption of inhalational anesthesia.…”

“…Our results are also in line with a systematic review conducted by Punjasawadwong which provides sufficient evidence to support the use of BIS-monitoring to guide anesthesia administration and to prevent intra-operative awareness [24]. Also our results are confirmed by the findings of Sandin et al who reported a reduced risk of awareness of 13% over a control group when BIS monitoring was used during general anesthesia [25].…”

“…In contrast, in a systematic review study of Punjasawadwong et al showed that regardless of the anesthetic used, BISguided anesthesia reduced all components of early recovery times, which is the time to open eyes, in response to the voice command, extubation and orientation [24]. We do not also agree with the study conducted by Kruerer et al who found that the time to open eyes, extubation and arrival to Post Anesthetic Care Unit (PACU) significantly reduced by using the BIS monitoring [33].…”

Extubation time in neurosurgical patients: does it matter?

“…Third, there were no data pertaining to BIS values after switching off the anesthetic agents. The BIS guided extubation is found to shorten the extubation time, so may influence the results of the present study [4]. Whether there were any additional opioids given and what method was adopted to prevent intraoperative awareness, were also not addressed.…”