title: Bispectral index monitoring for nurse-administered propofol sedation during upper endoscopic ultrasound: a prospective, randomized controlled trial.
abstract: Bispectral index monitoring (BIS) is a quantitative assessment of brain cortical activity. The aim of this study was to determine if BIS-guided nurse-administered propofol sedation would decrease by > or = 20% both recovery time and propofol dose compared to standard propofol sedation for endoscopic ultrasound (EUS). Prospectively, eligible outpatients were randomized to BIS-guided or standard propofol sedation during EUS. Propofol was given by nurses in intermittent boluses with sedation targeted at a BIS score of < 65-75. For the control group, the nurse was blinded to BIS scores and sedation was titrated to a modified observer's assessment of alertness/sedation scale (MOAA/S) score < or = 3. Of 50 patients enrolled, data for 44 randomized to BIS-guidance (n = 24) and the control group (n = 20) were evaluated. Between the BIS-guided and control group there was no difference between the mean procedure duration, total propofol dose, recovery time, mean intraoperative MOAA/S, and mean BIS score. Compared to standard propofol sedation for EUS, BIS-guided propofol sedation offers no significant decrease in postprocedure recovery times or propofol doses.
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA. jodewitt@iupui.edu
authors.forename: John M
authors.initials: JM
authors.lastname: DeWitt
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D015924:Blood Pressure Monitors; D004562:Electrocardiography; D004569:Electroencephalography; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009719:Nurse Anesthetists; D010045:Outpatients; D010100:Oxygen / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging*
chemical_list: D018686:Anesthetics, Intravenous; D010100:Oxygen; D015742:Propofol