Narcotrend or Bispectral Index Monitoring During Desflurane-Remifentanil Anesthesia: A Comparison with a Standard Practice Protocol

Abstract

Monitoring the electroencephalogram with Narcotrend or Bispectral Index during desflurane-remifentanil anesthesia only slightly reduces recovery times when compared with a standard practice protocol.

Clinical effectiveness and cost-effectiveness of depth of anaesthesia monitoring (E-Entropy, Bispectral Index and Narcotrend): a systematic review and economic evaluation

“…Uncertainty was greatest in relation to concealment of the random allocation process and blinding of participants and personnel, where details were unclear in all four trials. 59,60,63,64 Both the method of random sequence generation and blinding of outcome assessment were unclear in two trials, 59,60 with low risk of bias for these domains in the other two trials. 63,64 Risk of bias because of incomplete outcome data was low in all but one trial in which details were unclear.…”

“…59,60,63,64 Both the method of random sequence generation and blinding of outcome assessment were unclear in two trials, 59,60 with low risk of bias for these domains in the other two trials. 63,64 Risk of bias because of incomplete outcome data was low in all but one trial in which details were unclear. 60 In general, there appeared to be low risk of bias in terms of selective reporting of outcomes, as could be judged from the details reported in the trial publications.…”

“…Other sources of bias were reported for only one study where the paper was translated from Chinese to English prior to publication and it is unclear whether or not any checks were made to ensure fidelity of the published version to the original work. 59 The trials were conducted between 2003 and 2010 and trial sizes ranged from 120 patients 63,64 to 48 patients 60 and 40 patients. 59 All but the smallest study reported the use of a sample size calculation.…”

“…59 All but the smallest study reported the use of a sample size calculation. No attrition was reported for three trials 59,63,64 and these studies conducted ITT analyses. The fourth trial 60 reported attrition although not by study group, and analyses did not include all patients who started but it is unclear whether or not attrition happened pre or post randomisation.…”

“…There were seven (46%) 45,46,48,52,53,59,62 that included fewer than 100 patients and five (33%) 48,51,61,63,64 that had between 101 and 200 patients. One trial included 921 patients, 47 another included 5309 40 and another, the largest, included 6041 patients.…”