Efficacy of Bispectral Index Monitoring During Balanced Propofol Sedation for Colonoscopy: A Prospective, Randomized Controlled Trial

Yu, Yeon Hwa; Han, Dong Soo; Kim, Hyun Soo; Kim, Min Jung; Eun, Chang Soo; Yoo, Kyo-Sang; Shin, Woo Jong; Ryu, Seungho

doi:10.1007/s10620-013-2833-4

Cited by 19 publications

(19 citation statements)

References 23 publications

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“…assessing recovery time or patients' or endoscopists' satisfaction. [12][13][14][15][16] It has been demonstrated that intraoperative BIS monitoring facilitates the titration of anesthetic agents. Thus, it has the potential to decrease the use of anesthetic agents.…”

Section: Discussionmentioning

confidence: 99%

“…11 Previous studies on the use of BIS for sedation monitoring during colonoscopy mostly focused on decreasing the amount of sedative agent administered and the recovery time required, and on assessing the patient's or endoscopist's satisfaction. [12][13][14][15][16] The influence of depth of anesthesia on postoperative impairment of cognitive function among surgical patients has already been investigated through BIS monitoring. 17 Various medications have been compared in studies assessing postoperative impairment of cognitive function subsequent to procedures such as colonoscopy and endoscopic retrograde cholangiopancreatography (ERCP).…”

Section: Introductionmentioning

confidence: 99%

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The effect of bispectral index monitoring on cognitive performance following sedation for outpatient colonoscopy: a randomized controlled trial

Sargın

Uluer²,

Şimşek³

2019

Sao Paulo Med. J.

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BACKGROUND: Bispectral index (BIS) monitoring can positively affect cognitive performance through decreasing the use of sedative agents. We aimed to evaluate the effect of BIS monitoring on early cognitive performance among patients undergoing sedation for colonoscopy. DESIGN AND SETTING: Randomized, controlled trial in a university hospital. METHODS: 100 patients were randomized into two groups. In the monitored group (n = 50), the depth of anesthesia was monitored using the BIS, and BIS scores were maintained between 60 and 80. In the usual care group (n = 50), BIS monitoring was not performed. To determine the patients' baseline cognitive performance levels, the mini-mental state examination (MMSE), Trieger dot test (TDT) and clock drawing test (CDT) were used. The patients' post-procedure cognitive performance levels were determined when they were classified as ready for discharge. RESULTS: The total volume (mg) of propofol used [median (range) IQR] in the sedation procedure was lower in the monitored group [100 (50-200) 100-140] than in the usual care group [150 (75-200) 100-200] (P < 0.001). The discharge scores [mean (SD)] using MMSE and CDT were higher in the monitored group [26 (3) and 3 (1), respectively] than in the usual care group [23 (3) and 2 (1), respectively] (P = 0.002 and P = 0.002, respectively). The discharge scores using TDT [mean (SD)] were lower in the monitored group [11 (7)] than in the usual care group [15 (11)] (P = 0.033). CONCLUSION: BIS monitoring among sedated patients was associated with lower propofol use and smaller decline in cognitive performance. CLINICAL TRIAL REGISTRATION: This trial was registered in the Australian New Zealand Clinical Trial Registry (ACTRN12617000134325).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of bispectral index monitoring on cognitive performance following sedation for outpatient colonoscopy: a randomized controlled trial

Sargın

Uluer²,

Şimşek³

2019

Sao Paulo Med. J.

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“…Contrasting with previous results in flexible bronchoscopy [2], gastroscopy [3] and colonoscopy [4], Grendelmeier et al [1] found that conscious sedation with propofol was more risky than with midazolam given the higher incidence of hypoxemia (pulsed arterial oxygen saturation <90%: 27 vs. 4%) and hypotensive episodes (systolic blood pressure <90 mm Hg: 82 vs. 40%). These results also contradict the excellent safety profile that we reported in medical thoracoscopy when bispectral index monitoring, a clinical scale of sedation depth and end-tidal capnography were used by nonanesthetist nurses to more precisely titrate the intravenous administration of propofol and opiates [5].…”

Section: Financial Disclosure and Conflicts Of Interestmentioning

confidence: 64%

Propofol: Is It Really Worse than Midazolam in Medical Thoracoscopy?

Licker

Diaper²,

Tschopp³

2015

Respiration

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“…When compared with procedural sedation, BIS monitoring has several advantages. It is an objective method of monitoring sedation that has been widely used in various surgical and endoscopic procedures: a BIS value of about 70 provides effective sedation for procedures like gastrointestinal endoscopy inspection and endoscopic submucosal dissection (Yu et al, 2013). BIS can also provide continuous monitoring of sedation depth, enabling the anesthesiologist to alter the depth of sedation in pace with the procedures.…”

Section: Bis-guided Sedation Is Feasible In Tavimentioning

confidence: 99%

Bispectral index-guided sedation in transfemoral transcatheter aortic valve implantation: a retrospective control study

Huang

Shi

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Transcatheter aortic valve implantation (TAVI) is a minimally invasive therapy for elderly patients with severe aortic valve stenosis who were refused surgical aortic valve replacement because of the high perioperative risk. Traditionally, this procedure has been done under general anesthesia, but more recently local anesthesia and sedation have become popular. This research assessed the effectiveness of transfemoral TAVI under bispectral index (BIS)-guided sedation. Methods: In this single-center retrospective control analysis, clinical data, including demographic characteristics, echocardiography, periprocedural data, and main complications, were collected and assessed in 113 patients undergoing TAVI through the femoral artery under general anesthesia (GA group, n=36) and under BIS-guided sedation (SED group, n=77). Results: The demographic characteristics and echocardiographic parameters between the two groups were similar (P>0.05). Two (2.6%) of patients were moved from BIS-guided sedation to general anesthesia for surgical reasons. Procedures were significantly shorter in the SED group than in the GA group ((127.10±44.43) min vs. (165.90±71.62) min, P=0.004). Patients in the SED group lost less blood and received significantly fewer red blood cells and catecholamines than those in the GA group (5.19% vs. 22.22%, P=0.017 and 67.53% vs. 97.22%, P<0.001). The length of hospital stay was significantly shorter and there were fewer pulmonary complications in the SED group than in the GA group. Thirty-day mortality was similar between the two groups. Conclusions: BIS-guided sedation is a feasible and safe approach for transfemoral TAVI. The anesthesiologist should choose the best anesthetic method according to the team's experience.

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Efficacy of Bispectral Index Monitoring During Balanced Propofol Sedation for Colonoscopy: A Prospective, Randomized Controlled Trial

Abstract: BIS and clinical sedation scores, MOAA/S scores, showed a high level of correlation. However, no significant efficacy was observed in the BIS group who underwent outpatient colonoscopy.

Cited by 19 publications

References 23 publications

The effect of bispectral index monitoring on cognitive performance following sedation for outpatient colonoscopy: a randomized controlled trial

The effect of bispectral index monitoring on cognitive performance following sedation for outpatient colonoscopy: a randomized controlled trial

Propofol: Is It Really Worse than Midazolam in Medical Thoracoscopy?

Bispectral index-guided sedation in transfemoral transcatheter aortic valve implantation: a retrospective control study

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