The use of bispectral index monitoring in education - a tool to improve nurse-anaesthetists practice.
OBJECTIVE
This paper is a report of a study to investigate whether monitoring depth of anaesthesia by bispectral index would reduce recovery time and consumption of anaesthetic drugs in anaesthetics performed by student nurse-anaesthetists.


BACKGROUND
It is difficult to assess the depth of anaesthesia clinically. Studies have shown that experienced anaesthetists can titrate anaesthetics more accurately when using bispectral index monitors. It is not known if student nurse-anaesthetists can benefit from their use in a similar way.


METHODS
A multicentre study involving four hospitals was carried out during a 13-month period in 2003 and 2004. In total 25 nurses participated, each contributing with two procedures: one with monitoring and one without. The nurses had at least 10 months of experience in conducting anaesthesia and all had a theoretical introduction and a test session to become familiar with the equipment. The sequence was randomized and the observer was blinded to whether a monitor was used. Fifty patients were anaesthetized with propofol and fentanyl. Recovery time, consumption of anaesthetic drugs, and patient satisfaction were measured in both groups.


RESULTS
Recovery time was 11 minutes in the monitor group (range: 2-53 minutes) and 15 minutes in the control group, (range: 3-60 minutes). P = 0.26. There were no statistically significant differences in consumption of anaesthetic drugs or patient satisfaction in the two groups.


CONCLUSIONS
It was not possible to demonstrate a statistically significant reduction in recovery time or consumption of anaesthetic drugs when using bispectral index monitoring during training of student nurse-anaesthetists.
Vedtofte
Jakob I
JI
Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Copenhagen, Denmark. jakob.vedtofte@rh.regionh.dk
Rasmussen
Lars S
LS
D000328:Adult; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003718:Denmark; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009719:Nurse Anesthetists / Q000193:education*; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage; D013663:Teaching / Q000379:methods*
D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol