Bispectral index values during elective rigid bronchoscopy: a prospective observational pilot study.
Rigid bronchoscopy is associated with a high incidence of haemodynamic disturbance and awareness under anaesthesia. Anaesthetic agents are given both to attenuate the sympathetic response to bronchoscopy and to prevent awareness. Use of the Bispectral index to guide anaesthesia has shown to reduce awareness and improve recovery times from general anaesthesia. We undertook a prospective observational study of BIS values in 50 patients during routine anaesthesia for rigid bronchoscopy. BIS values were found to be between 40-60 during bronchoscopy for only 0.5% of the time (0-11.5%[0-98.7%]), median (interquartile range [range]). Patients had a BIS < 40 for 99.6% (87.9-100%[0-100%]) of the duration of bronchoscopy. We identified one case of possible awareness. Few of our patients undergoing general anaesthesia for rigid bronchoscopy had BIS scores in the suggested range of between 40 and 60. BIS < 40 was more frequent than in previous studies of different surgical populations. There was no difference in the BIS values of patients anaesthetised with intermittent boluses or target controlled infusions of propofol.
Bould
M D
MD
Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK. dylanbould@yahoo.co.uk
Mahtani
D G
DG
Davies
R
R
Roughton
M
M
Hunter
D N
DN
Kelleher
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000771:Anesthesia, Intravenous / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology; D001364:Awareness / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001999:Bronchoscopy; D004334:Drug Administration Schedule; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010865:Pilot Projects; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology; D011446:Prospective Studies
D018686:Anesthetics, Intravenous; D015742:Propofol