OBJECTIVE: In this study, we aimed to investigate the effects of bispectral index (BIS) and neuromuscular blockade monitoring on the depth of anaesthesia and recovery in cardiac patients, scheduled to undergo open cholecystectomy operation with desflurane anaesthesia. METHODS: After the approval of the Ethics Committee and consent from the patients, patients were randomly divided into two groups. All patients received standard induction drugs, and 4-6% desflurane was used for maintenance of anaesthesia. In Group I, the anaesthesiologist was blind to BIS, and end-tidal volatile agent concentration (ETVAC) of desflurane was titrated according to the patients' hemodynamic changes. In Group II, ETVAC of desflurane was titrated to maintain BIS at 50-60. The hemodynamic data, BIS values, end-tidal volatile agent concentration (ETVAC) and train of four (TOF) values were recorded at pre-induction, post-induction, post-intubation, 1st and 5th minutes after surgical incision and then every 15 min. At the end of the operation, extubation time and the time to reach an Aldrete recovery score ≥9 were recorded in each group. Additionally, neuromuscular agent and narcotic agent doses were recorded. RESULTS: The BIS values were lower for Group I in all times, except pre- and post-induction times (p<0.05). ETVAC values of all times were lower for Group II (p<0.05). CONCLUSION: The requirement of volatile agent, which was given according to BIS monitoring, was lower than in the standard technique, but it is considered not to affect the early extubation, recovery and neuromuscular agent requirement dependent on TOF monitoring.
RCT Entities:
OBJECTIVE: In this study, we aimed to investigate the effects of bispectral index (BIS) and neuromuscular blockade monitoring on the depth of anaesthesia and recovery in cardiac patients, scheduled to undergo open cholecystectomy operation with desflurane anaesthesia. METHODS: After the approval of the Ethics Committee and consent from the patients, patients were randomly divided into two groups. All patients received standard induction drugs, and 4-6% desflurane was used for maintenance of anaesthesia. In Group I, the anaesthesiologist was blind to BIS, and end-tidal volatile agent concentration (ETVAC) of desflurane was titrated according to the patients' hemodynamic changes. In Group II, ETVAC of desflurane was titrated to maintain BIS at 50-60. The hemodynamic data, BIS values, end-tidal volatile agent concentration (ETVAC) and train of four (TOF) values were recorded at pre-induction, post-induction, post-intubation, 1st and 5th minutes after surgical incision and then every 15 min. At the end of the operation, extubation time and the time to reach an Aldrete recovery score ≥9 were recorded in each group. Additionally, neuromuscular agent and narcotic agent doses were recorded. RESULTS: The BIS values were lower for Group I in all times, except pre- and post-induction times (p<0.05). ETVAC values of all times were lower for Group II (p<0.05). CONCLUSION: The requirement of volatile agent, which was given according to BIS monitoring, was lower than in the standard technique, but it is considered not to affect the early extubation, recovery and neuromuscular agent requirement dependent on TOF monitoring.
Entities:
Keywords:
Bispectral index; anaesthesia; desflurane; recovery period
Authors: Michael S Avidan; Lini Zhang; Beth A Burnside; Kevin J Finkel; Adam C Searleman; Jacqueline A Selvidge; Leif Saager; Michelle S Turner; Srikar Rao; Michael Bottros; Charles Hantler; Eric Jacobsohn; Alex S Evers Journal: N Engl J Med Date: 2008-03-13 Impact factor: 91.245