Predictor of sedation during endoscopic retrograde cholangiopancreatography--bispectral index vs clinical assessment.
BACKGROUND
The bispectral index (BIS) has been developed as a monitor of sedation in patients receiving anesthetic and sedative drugs. BIS has been shown to correlate with responsiveness under sedation and anesthesia with a variety of agents. This study was designed to compare BIS with clinical assessment of sedation during ERCP.


METHODS
Forty patients were divided into two equal groups: Group I: The sedation level monitored by clinical assessment. Group II: The sedation level monitored by BIS. The patients in both groups did not receive any premedication and the procedure started after sedating the patients with 0.1 mg/kg midazolam and 1 microg/kg fentanyl, additional doses of midazolam were given according to the level of sedation either guided by BIS or clinical assessment. All vital signs and sedation level were monitored, the total dose of sedation was calculated and the rate of recovery and operator's satisfaction rate were evaluated.


RESULTS
There was a statistical significant difference between both groups regarding sedative duration, recovery rate, satisfaction rate and the total dose of sedative with non-significant difference in vital signs monitoring.


CONCLUSIONS
These results imply that BIS may be a valuable monitor for safe level of sedation and operator's satisfaction during ERCP.
Al-Sammak
Z
Z
Salmaniya Medical Complex, Anaesthesia Department, Kingdom of Bahrain. maxgasan@batelco.com.bh
Al-Falaki
M M
MM
Gamal
H M
HM
D000293:Adolescent; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D016292:Procedural Sedation; D004569:Electroencephalography; D005260:Female; D005283:Fentanyl / Q000494:pharmacology; D006801:Humans; D008297:Male; D008874:Midazolam / Q000494:pharmacology; D008875:Middle Aged; D010100:Oxygen / Q000097:blood
D008874:Midazolam; D010100:Oxygen; D005283:Fentanyl