Assessment of Depth of Anesthesia: prst Score Versus Bispectral Index

Abstract

a ssessment of depth of anesthesia is the basis in anesthesiologist ' s work because the occurrence of awareness during general anesthesia is important due to stress, which is caused in the patient at that moment, and due to complications that may arise later. There are subjective and objective methods used to estimate the depth of anesthesia. The aim of this study was to assess the depth of anesthesia based on clinical parameters and on the basis bispectral index, and determine the part of bispectral monitoring in support to clinical assessment. Material and methods: Sixty patients divided into two groups were analyzed in a prospective study. In first group (group 1), the depth of anesthesia was assessed by PRST score, and in the second group (group 2) was assessed by bispectral monitoring with determination PRST score concurrently. In both groups PRST score was assessed in four periods, while bispectral monitoring is used continuously. For analysis were used the BIS index values from the equivalent periods as PRST scores. PRST score value 0-3, and BIS index 40-60 were considered as adequate depth of anesthesia. The results showed that in our study were not waking patients during the surgery. In the group where the depth of anesthesia assessed clinically, we had a few of respondents (13%) for whom at some point were present indicators of light anesthesia. Postoperative interview excluded the possibility of intraoperative awareness. In the second group of patients and objective and clinical assessment indicated at all times to adequate depth of anesthesia. Conclusion: The use of BIS monitoring with clinical assessment allows anesthesiologists precise decision-making in balancing and dosage of anesthetics and other drugs, as well as treatment in certain situations.

An Alternative Position for the BIS-Vista Montage in Frontal Approach Neurosurgical Cases

“…This was not physically plausible. Notably, this study did not address some of the larger questions and relating to the general debate surrounding the utility and efficacy of the BIS [13][14][15][16][17][18][19] and the fact that the BIS calculation paradigm is proprietary information not available to us. Our study did not control for type of case or type of anesthetic used, or stage of anesthesia, all of which have been demonstrated to affect BIS values.…”

Falsely increased bispectral index values by convective air warming system during kidney transplantation

“…The value of BIS is superior to clinical signs for hypnotic effect of anesthesia. 2 However, several anesthetics, devices and clinical conditions could affect BIS value. 1 …”

Comparative Efficacy of Bispectral Index Monitoring and Clinical Assessment in The Recovery of Patients Undergoing Open Renal Surgery: A Randomized, Double-Blind Study

“…A clinical assessment may not be able to properly tell us the condition of the patient's consciousness and pain intensity due to the fact that the patient's hemodynamic variables that act related to autonomic nervous system are influenced by other factors. Nevertheless, Smajic et al suggests that BIS monitoring should be used alongside clinical factors and not recommended to be used alone (2).…”

“…Maintaining an adequate depth of anesthesia in the intraoperative period is considered as one of the main points of anesthesia that is dependent to adequate doses of anesthetic (2). As a low dose of drugs leads to awareness, generous doses lead to significant disturbance in the hemodynamic parameters (such as heart rate and blood pressure), delayed recovery, and an increase in other complications; therefore increasing the depth of anesthesia at aged patients and certain patients is considered important (2)(3)(4)(5)(6)(7). Selecting an appropriate supervision can help optimize the quality of drug delivery, possibly reduce costs, and improve the outcomes of surgery (8).…”