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Bispectral index monitoring in patients undergoing cardiac surgery under cardiopulmonary bypass

Published online by Cambridge University Press:  11 July 2005

G. D. Puri  and
S. S. Murthy
G. D. Puri
Affiliation:
Postgraduate Institute of Medical Education and Research, Department of Anaesthesiology and Intensive Care, Chandigarh, India
S. S. Murthy
Affiliation:
Postgraduate Institute of Medical Education and Research, Department of Anaesthesiology and Intensive Care, Chandigarh, India
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Extract

Summary

Background and objective: Monitoring the depth of anaesthesia by the bispectral index facilitates the titration of anaesthetic drugs during operation as well as assisting in early recovery. We planned to use this index to control the administration of anaesthetic agents in order to stabilize haemodynamics and promote recovery from anaesthesia in patients undergoing cardiac surgery with cardiopulmonary bypass.

Methods: Thirty adult patients undergoing valve replacement or coronary artery grafting under cardiopulmonary bypass were studied in a prospective, randomized, controlled study. Bispectral index monitoring was used in all patients. Patients received isoflurane anaesthesia and boluses of morphine: in the study group, anaesthetic depth was controlled using the bispectral index and clinical variables. In the control group, the bispectral index monitor could not be viewed by the anaesthesiologist. Bispectral index, mean arterial pressure and heart rate were noted every 5 min, and the incidence of hypotension, hypertension, tachycardia and bradycardia also noted. The time to recovery, when patients started obeying commands, was also recorded.

Results: Patients in the study group had significantly less hypertension and tachycardia (P < 0.05) than those in the control group. The time to recovery of consciousness was less in the study group than in the control group (n.s., P > 0.05). The bispectral index rose significantly in the control group at the time of institution and termination of cardiopulmonary bypass (P < 0.05).

Conclusions: Anaesthesia controlled by bispectral index monitoring decreases the incidence of haemodynamic disturbances and facilitates titration of anaesthetic agents during cardiopulmonary bypass and thus may assist recovery from anaesthesia.

Keywords

CARDIAC SURGICAL PROCEDURES, myocardial revascularization, coronary artery bypassDIAGNOSTIC TECHNIQUES, NEUROLOGICAL, electroencephalographySURGICAL PROCEDURES, OPERATIVE, extracorporeal circulation, cardiopulmonary bypass
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 6 , June 2003 , pp. 451 - 456
Copyright
© 2003 European Society of Anaesthesiology

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References

Vernon JM, Lang E, Sebel PS, Manberg P. Prediction of movement using bispectral electroencephalographic analysis during propofol/alfentanil or isoflurane/alfentanil anesthesia. Anesth Analg 1995; 80: 780–785.Google Scholar
Liu J, Singh H, White PF. Electro encephalogram bispectral analysis predicts the depth of midazolam-induced sedation. Anesthesiology 1996; 84: 64–69.Google Scholar
Kearse Jr LA, Manberg P, Chamoun N, Debros F, Zaslavsky A. Bispectral analysis of the electroencephalogram correlates with patient movement to skin incision during propofol/nitrous oxide anesthesia. Anesthesiology 1994; 81: 1365–1370.Google Scholar
Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology 1997; 87: 842–848.Google Scholar
Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil and nitrous oxide anesthesia. Anesthesiology 1997; 87: 808–815.Google Scholar
Hug CC. Does opioid ‘Anesthesia’ exist? Anesthesiology 1990; 73: 1–4.Google Scholar
Barr G, Anderson RE, Samuelsson S, Owall A, Jakobsson JG. Fentanyl and midazolam anaesthesia for coronary bypass surgery: a clinical study of bispectral electroencephalogram analysis, drug concentrations and recall. Br J Anaesth 2000; 84: 749–752.Google Scholar
Doi M, Gajraj RJ, Mantzaridis H, Kenny GNC. Effect of cardiopulmonary bypass and hypothermia on electroencephalographic variables Anaesthesia 1997; 52: 1048–1055.Google Scholar
Schmidlin D, Haer P, Schmid ER. Monitoring level of sedation and bispectral EEG analysis between hypothermic and normothermic cardiopulmonary bypass. Br J Anaesth 2000; 86: 769–776.Google Scholar
Roizen MF, Toledano A. Technology assessment and the learning contamination bias. Anesth Analg 1994; 79: 410–412.Google Scholar
Kumar A, De Deyne C, Struys M, Vundelinckx G, Heylen R. Use of bispectral EEG monitoring to evaluate training in anesthesia. Br J Anaesth 1999; 82 (Suppl): A47.Google Scholar
Sandin RH. Awareness during anaesthesia: a prospective case study. Lancet 2000; 355: 707–711.Google Scholar