title: The impact of bispectral index monitoring on rates of propofol administration.
abstract: The purpose of this article is to examine the efficacy of Bispectral Index (BIS) monitoring as a tool for adjusting the amount of propofol patients receive to maintain a safe and adequate level of sedation in a neurocritical care setting. The BIS monitor is utilized as an adjunct for anesthesia monitoring in the operating room setting and is currently being investigated as a tool for objective sedation monitoring in the critical care setting. 1-6 Sedation is discussed in terms of patient safety and comfort. A secondary data analysis was used to test the hypothesis that BIS monitoring provides a more objective form of sedation assessment that will lead to a decrease in overall rates of propofol administration and fewer incidences of oversedation. Data were abstracted from a quality improvement study of propofol use adjusted to BIS values in patients whose sedation levels were previously adjusted to a goal Ramsay score. The results suggest that there are potential benefits to incorporating BIS into routine sedation assessment in the neurocritical care setting.
authors.affiliation: Duke University Hospital, Durham, NC 27710, USA. dmolson@email.unc.edu
authors.forename: DaiWai M
authors.initials: DM
authors.lastname: Olson
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Cheek
authors.forename: Joel C
authors.initials: JC
authors.lastname: Morgenlander
mesh_terms: D000328:Adult; D015400:Clinical Nursing Research; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D003422:Critical Care / Q000379:methods* / Q000592:standards; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods* / Q000451:nursing; D004569:Electroencephalography / Q000379:methods* / Q000451:nursing / Q000592:standards; D004576:Electromyography / Q000379:methods* / Q000451:nursing / Q000592:standards; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D015742:Propofol / Q000008:administration & dosage*; D017751:Safety Management / Q000379:methods; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors; D017749:Total Quality Management / Q000458:organization & administration; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol