Bispectral index system (BIS) monitoring reduces time to extubation and discharge in children requiring oral presedation and general anesthesia for outpatient dental rehabilitation.
OBJECTIVE
Pediatric oral rehabilitation patients who receive presedation with oral Versed and general anesthesia (GA) occasionally experience prolonged sedation and delayed discharge. The Bispectral Index System (BIS) is an EEG monitor that measures the anesthesia level. The purpose of this study was to compare the effects of monitoring the BIS to not monitoring the BIS on time from discontinuation of GA to extubation and to discharge.


METHODS
Twenty-nine children were enrolled. BIS was monitored from admission until discharge. Each child received 0.7 mg/kg of oral Versed. In the operating room, GA with sevoflurane (IH), rocuronium 1 mg/kg (IV), fentanyl 1 microg/kg (IV), and ondansetron 0.15 mg/kg (IV) was administered. Randomly, in half the patients, the anesthesiologist maintained the level of anesthesia and BIS by adjusting sevoflurane. In the rest, the anesthesiologist did not know BIS. The time from turning off sevoflurane to discharge was compared.


RESULTS
Group 1 patients were extubated 5+/-2 minutes sooner than group 2 patients (P=.04). The post-anesthesia care unit stay for group 1 patients was 47+/-17 minutes compared to 63+/-17 minutes in group 2. (p=0.02).


CONCLUSIONS
Monitoring anesthesia with BIS promotes earlier extubation and discharge for pediatric dental patients who receive oral Versed and sevoflurane GA.
Department of Anesthesiology, University of Illinois, Chicago, Ill, USA. messieha@uic.edu
Z S
ZS
Messieha
R C
RC
Ananda
W E
WE
Hoffman
I C
IC
Punwani
H M
HM
Koenig
D000284:Administration, Oral; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods*; D000768:Anesthesia, General / Q000295:instrumentation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001794:Blood Pressure; D002675:Child, Preschool; D003814:Dentistry, Operative; D017050:Episode of Care; D005260:Female; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D011229:Preanesthetic Medication; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method; D017186:Titrimetry
D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D008874:Midazolam