Effect of bispectral index versus end-tidal anesthetic gas concentration-guided protocol on time to tracheal extubation for halothane-based general anesthesia

Abstract

Background and Aims:Early extubation is a desirable goal after general anesthesia. Very few studies have compared the effect of bispectral index (BIS) monitoring versus standard end-tidal anesthetic gas (ETAG) concentration monitoring on tracheal extubation time for halothane-based anesthesia. The aim of this study was to compare the effect of BIS versus ETAG-guided anesthesia on time to tracheal extubation for halothane-based anesthesia in general surgical setting.Methods:This was a randomized, controlled double-blind study. Sixty patients with the American Society of Anesthesiologists physical status Class 1 or 2, receiving halothane-based general anesthesia were randomized to BIS-guided (n = 30) and ETAG-guided anesthesia (n = 30). Time to tracheal extubation was measured. In BIS group, BIS value was kept between 40 and 60 while in ETAG group; ETAG value was kept between 0.7 and 1.3 minimum alveolar concentration. The two groups were compared using Student's t-test, and P < 0.05 was considered statistically significant. Data were processed and analyzed using SPSS version 17 software.Results:Mean time to tracheal extubation was significantly longer in BIS group (9.63 ± 3.02 min) as compared to ETAG group (5.29 ± 1.51 min), mean difference 4.34 min with 95% confidence interval (3.106, 5.982) (P < 0.05).Conclusion:In our study, the extubation time was significantly longer in BIS-guided anesthesia as compared to ETAG-guided anesthesia. ETAG monitoring promotes earlier extubation of patients as compared to BIS monitoring during halothane anesthesia.

Comparison of Fat-Free Mass and Ideal Body Weight Scalar for Anesthetic Induction Dose of Propofol in Patients with Morbid Obesity: A Double-Blind, Randomized Clinical Trial

“…2023; 13(6):e140027. measure; however, since there is a few seconds time lag for processing data, a clinical measure, the disappearance of eyelash reflex, was taken to estimate the propofol onset of action as well (28,29). To evaluate the adequacy of anesthesia, episodes of BIS > 60 or straining during intubation or opening the eyes were determined.…”

Comparison of end-tidal anesthetic gas concentration versus bispectral index-guided protocol as directing tool on time to tracheal extubation for sevoflurane-based general anesthesia

“…However, Jain et al [ 4 ] performed a study with halothane and found contrarily significantly ( P < 0.05) shorter extubation time in the ETAG-guided group (5.29 ± 1.51 min) as compared to BIS-guided group (9.63 ± 3.02 min) (mean difference 4.34 min with 95% confidence interval [3.106, 5.982]). The probable reason may be the inhalational agent used, i.e.…”

“…Sample size calculation was based on assuming a difference of 4.34 min in both groups with 95% confidence interval, 5% alpha error using G-power 3.1 Software [Heinrich Heine University, Dusseldorf, Germany]. [ 4 ] The quantitative variables were compared using unpaired t -test and qualitative variables were compared using the Chi-square/Fisher's exact test. P < 0.05 was considered statistically significant.…”