The Effect of BIS Usage on Anaesthetic Agent Consumption, Haemodynamics and Recovery Time in Supratentorial Mass Surgery

Karaca, İclal; Akçıl, Fatma Eren; Dilmen, Özlem Korkmaz; Köksal, Güniz Meyancı; Tunalı, Yusuf

doi:10.5152/tjar.2014.24892

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…Karaca et al found that time to spontaneous breathing was shorter and time to eye opening was longer when BIS was used compared to the control group, although these differences were not statistically significant [ 18 ]. They concluded that it was difficult to say whether there was a significant difference in terms of total cost when BIS monitoring was used.…”

Section: Discussionmentioning

confidence: 99%

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Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial

et al. 2018

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BackgroundWe compared cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring, in the clinical setting of ear-nose-throat surgery.MethodsOne hundred twenty adult patients were randomized to four groups. In groups SEVO and SEVO+ anesthesia was maintained with sevoflurane, in group SEVO+ with additional bispectral index (BIS) and train-of-four (TOF) monitoring. In groups PROP and PROP+ anesthesia was maintained with propofol, in group PROP+ with additional BIS and TOF monitoring.ResultsTotal cost of anesthesia per hour was greater in group SEVO+ compared to SEVO [€ 19.95(8.53) vs. 12.15(5.32), p < 0.001], and in group PROP+ compared to PROP (€ 22.11(8.08) vs. 13.23(4.23), p < 0.001]. Time to extubation was shorter in group SEVO+ compared to SEVO [11.1(4.7) vs. 14.5(3.9) min, p = 0.002], and in PROP+ compared to PROP [12.6(5.4) vs. 15.2(4.7) min, p < 0.001]. Postoperatively, arterial blood pressure returned to its initial values sooner in groups SEVO+ and PROP+.ConclusionsOur study demonstrated that the use of BIS and TOF monitoring decreased the total cost of anesthesia drugs and hastened postoperative recovery. However, in our circumstances, these were associated with higher disposables costs. Detailed cost analysis and further investigations are needed to identify patient populations who would benefit most from additional monitoring.Trial registrationClinicalTrials.gov, NCT02920749. Retrospectively registered (date of registration September 2016).

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Section: Discussionmentioning

confidence: 99%

“…With total intravenous anesthesia techniques the need for disposables (syringe, extension tube for infusion set, valve) increases total cost [ 14 , 15 ]. Some studies compared the cost of anesthesia with BIS vs. hemodynamic monitoring [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial

et al. 2018

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“…e bispectral index (BIS), derived from electroencephalogram, is the most commonly used and accepted monitor for assessing the level of sedation and depth of anesthesia [10,[12][13][14][15]. BIS predicts movement in response to surgery and detects consciousness under different anesthetic drugs [15][16][17][18]. It is also a tool that may reduce the incidence of unexpected recall [10,12,13,18].…”

Section: Introductionmentioning

confidence: 99%

A Crossover Comparison of the Sensitivity and the Specificity between BIS and AEP in Predicting Unconsciousness in General Anesthesia

Huang

Wang

Gao

et al. 2020

Scientific Programming

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Background. There is an increasing concern of awareness and recall during general anesthesia for both the patient and the anesthetist. The bispectral index (BIS) is used to assess the level of sedation and depth of anesthesia and detect consciousness in different anesthetic drugs. Middle-latency auditory evoked potentials (AEPs) also quantify action of anesthetic drugs and detect the transition from consciousness to unconsciousness. We aim to compare the sensitivity and specificity between BIS and AEP in predicting unconsciousness in inhalational sevoflurane anesthesia and intravenous propofol anesthesia. Methods. Totally, 40 patients were randomly allocated into two groups: propofol or sevoflurane group. In the propofol group, anesthesia was induced with target-controlled infusion propofol. In the sevoflurane group, anesthesia was induced by increasing concentrations of sevoflurane. There were 3 end points during induction: sedation, unconsciousness, and anesthesia. Target and effect-site concentrations of propofol, end-tidal concentration of sevoflurane, and BIS and AEP were recorded at each stage. Results. We obtained good EC50 with both monitors, at which there is a 50% chance that the patient has reached the end point, but the index variation was affected by the anesthetic technique. Propofol had higher correlations with stage of anesthesia, BIS, and AEP than sevoflurane. BIS had higher correlations with depth of anesthesia than AEP, but we did not find an anesthetic depth monitor that had high sensitivity and specificity and is not affected by the anesthetic technique. Conclusions. The prediction powers of BIS and AEP do not seem as good as some papers mentioned.

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Bispectral index for improving anaesthetic delivery and postoperative recovery

Punjasawadwong

Phongchiewboon

Bunchungmongkol

2014

Cochrane Database of Systematic Reviews

279

220

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BIS-guided anaesthesia can reduce the risk of intraoperative awareness in surgical patients at high risk for awareness in comparison to using clinical signs as a guide for anaesthetic depth. BIS-guided anaesthesia and ETAG-guided anaesthesia may be equivalent in protection against intraoperative awareness but the evidence for this is inconclusive. In addition, anaesthesia guided by BIS kept within the recommended range improves anaesthetic delivery and postoperative recovery from relatively deep anaesthesia.

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The Effect of BIS Usage on Anaesthetic Agent Consumption, Haemodynamics and Recovery Time in Supratentorial Mass Surgery

Abstract: Although using BIS monitoring to evaluate depth of anaesthesia does not bring much benefit versus the use of haemodynamic parameters, it may be beneficial for selected surgeries such as awake craniotomy, for patients with a history of awareness and in haemodynamically unstable patients.

Cited by 7 publications

References 13 publications

Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial

Cost-effectiveness of anesthesia maintained with sevoflurane or propofol with and without additional monitoring: a prospective, randomized controlled trial

A Crossover Comparison of the Sensitivity and the Specificity between BIS and AEP in Predicting Unconsciousness in General Anesthesia

Bispectral index for improving anaesthetic delivery and postoperative recovery

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