European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000
Background and goal of study: Monitoring of EEG bispectral index (BIS) may help to optimize anaesthesia . We tested the hypothesis that monitoring of BIS during sevoflurane-N2O anaesthesia improves recovery and home-readiness after gynaecological outpatient laparoscopy when compared to conventional anaesthesia.
Patients and methods: The study was approved by the local IRB. 62 patients were studied after informed consent, and randomized into two groups after propofol induction. In BIS group, sevoflurane was titrated to keep BIS between 50-60 during surgery. In MAC group, 0.9% ET sevoflurane was given, and later on adjusted to keep haemodynamic parameters within 25% of control values; BIS was recorded but not displayed. Consumption of drugs, severity of pain, postoperative nausea and vomiting (PONV) and recovery parameters were recorded.
Results and discussion: Demographics and anaesthesia parameters were similar (Table). Consumption of drugs was similar in both groups. Nine patients in MAC group, and no one in BIS group, had BIS below 40 (P<0.01). Orientation in BIS group was faster than in MAC group [6.7; 5.9-7.5 vs. 8.2; 7.3-9.1 min (median; range)]. In psychomotor recovery test, BIS group scored better at 30 min after surgery (P<0.01). In Phase II recovery area BIS group had less nausea (P<0.05). No difference was seen in other parameters. BIS monitoring helped to optimize sevoflurane anaesthesia and improved immediate recovery.
Conclusion: Monitoring of BIS improves the quality of recovery after gynaecological outpatient laparoscopy, without an effect on home-readiness.
1 Yli-Hankala et al. Acta Anesthesiol Scand
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