Background and Aims:
End-tidal anaesthetic gas concentration (ETAG) and bispectral index (BIS) are both used to monitor depth of anaesthesia. Maintaining an accurate depth of anaesthesia helps in early post-operative recovery. This study compared the recovery times from sevoflurane–nitrous oxide anaesthesia using ETAG monitoring with BIS monitoring.
Methods:
Four hundred and two patients undergoing elective surgeries under sevoflurane- nitrous oxide anaesthesia were enroled in this double blinded parallel group prospective randomised trial and allocated into two groups. The depth of anaesthesia was monitored using BIS in BIS group (
n
= 202) and end-tidal sevoflurane concentration (EtSevo) in ETAG group (
n
= 200). The time to extubation and recovery were compared between the groups. Parametric, non-parametric and categorical variables were compared using Student’s ‘
t
’ test, Wilcoxon’s rank sum test and Chi-square test, respectively.
Results:
Time to extubation (min) [BIS group – 10, 5; ETAG group – 10, 5 (median, inter-quartile range, IQR),
P
= 0.32] and time to recovery (min) [BIS group – 14, 6; ETAG group – 13.5, 7 (median, IQR),
P
= 0.34] did not differ significantly between the two groups. The EtSevo concentration (vol%) was significantly higher in the BIS group at 5 min [BIS group – 1.2, 0.4; ETAG group – 1.0, 0.4 (median, IQR),
P
< 0.001], 30 min [BIS group – 1.1, 0.4; ETAG group – 1.0, 0.3 (median, IQR),
P
= 0.002] and 120 min [BIS group – 1.11 ± 0.28; ETAG group – 0.96 ± 0.27 (mean ± standard deviation),
P
= 0.014] after induction of anaesthesia.
Conclusions:
BIS and ETAG monitoring are associated with comparable recovery profiles. ETAG monitoring is associated with significantly less sevoflurane consumption.