title: Utility of bispectral index monitoring during intravenous sedation in the dental office.
abstract: OBJECTIVE
  This research sought to compare two different systems to monitor sedated patients undergoing implant surgery in the dental office: the bispectral index (BIS) and the Ramsay scale. This information was used to establish an optimal BIS range for surgery in these patients and to calculate differences in drug consumption in both groups.
  
  
  METHODS
  Consecutive patients undergoing implant surgery were studied and randomly assigned to two groups. Patients were sedated using intravenous propofol, fentanyl, and midazolam. The sedation level in group A was measured using the Ramsay scale. In group B, the Ramsay scale and the BIS were used together. Heart rate, blood pressure, and peripheral oxygen saturation were monitored in all patients. The levels of anxiety, satisfaction, and drug consumption were compared between groups.
  
  
  RESULTS
  Forty-three patients were included; 20 were placed in group A and 23 were included in group B. There were no differences in the hemodynamic and respiratory parameters monitored or in anxiety or satisfaction levels in both groups. In group B patients, the BIS values stabilized around 85; the Ramsay scale stabilized around 3 in both groups and remained at these levels until the end of the procedure. Drug consumption was significantly lower in the BIS group.
  
  
  CONCLUSIONS
  The optimal BIS value during intravenous sedation in sedated ambulatory patients in dental surgery should be within the 80 to 85 range. BIS monitoring allows for reduced consumption of propofol, fentanyl, and midazolam.
authors.affiliation: Hospital Sur, Madrid, Spain. mugarmedical@ono.com
authors.forename: Juan
authors.initials: J
authors.lastname: Munoz Garcia
authors.forename: Alfonso Vidal
authors.initials: AV
authors.lastname: Vidal Marcos
authors.forename: Andres
authors.initials: A
authors.lastname: Restoy Lozano
authors.forename: Carmen
authors.initials: C
authors.lastname: Gasco Garcia
mesh_terms: D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods; D000766:Anesthesia, Dental / Q000379:methods; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001007:Anxiety / Q000145:classification; D001794:Blood Pressure / Q000187:drug effects; D003243:Consciousness / Q000187:drug effects; D056805:Consciousness Monitors; D054810:Deep Sedation / Q000145:classification / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D019647:Oral Surgical Procedures / Q000379:methods*; D010100:Oxygen / Q000097:blood; D017060:Patient Satisfaction; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D010100:Oxygen; D005283:Fentanyl; D015742:Propofol