title: Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane?
abstract: This study was designed to test the hypothesis that outpatients with higher electroencephalographic (EEG) Bispectral Index (BIS) values at the end of anesthesia achieve a modified Aldrete score of 10 and satisfy fast-track eligibility criteria more rapidly after ambulatory surgery. Sixty consenting women undergoing laparoscopic tubal ligation procedures were studied. After premedication with midazolam 2 mg IV, anesthesia was induced with propofol 2 mg/kg IV, fentanyl 1.5 microg/kg IV, and succinylcholine 1 mg/kg IV and was initially maintained with either desflurane 4% (n = 31) or a propofol infusion 100 microg kg(-1) min(-1) (n = 29), in combination with nitrous oxide 65% in oxygen. Subsequently, the inspired desflurane concentrations (2%-6%) and propofol infusion rates (50-150 microg.kg(-1) min(-1) were varied to maintain a clinically acceptable depth of anesthesia. The average BIS value during the 3-min interval immediately before the discontinuation of the maintenance anesthetics was recorded. Emergence times and modified Aldrete scores were assessed from the end of anesthesia until patients were considered fast-track-eligible. The BIS values at the end of anesthesia were significantly correlated with the time to reach fast-track eligibility in both the desflurane (r = -0.68) and propofol (r = -0.76) groups. We concluded that the EEG-BIS value at the end of anesthesia is useful in predicting fast-track eligibility after laparoscopic tubal ligation procedures with either a desflurane- or propofol-based anesthetic technique.
  
  
  CONCLUSIONS
  In outpatients receiving either desflurane and propofol anesthesia for laparoscopic tubal ligation surgery, the times to achieve criteria for bypassing the recovery room (i.e., fast-tracking) correlated with the electroencephalographic-Bispectral Index values at the end of anesthesia.
authors.affiliation: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 75235-9068, USA.
authors.forename: D
authors.initials: D
authors.lastname: Song
authors.forename: J
authors.initials: J
authors.lastname: van Vlymen
authors.forename: P F
authors.initials: PF
authors.lastname: White
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives*; D015742:Propofol; D011446:Prospective Studies
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D007530:Isoflurane; D015742:Propofol