title: [Usefulness of monitoring anaesthesia with the bispectral index in upper gastrointestinal endoscopies with spontaneous breathing].
abstract: BACKGROUND
  The objective of this investigation is to determine whether bispectral index (BIS®) monitoring during intravenous anaesthesia with spontaneous breathing for upper gastrointestinal endoscopy (UGE) in a pediatric population is useful for: a) decreasing the amount of drug, b) decreasing the time for awakening, and c) improving patient safety.
  
  
  METHODS
  A quasi-experimental case-control prospective study was conducted in the setting of a second level hospital pediatric intensive care unit.
  
  
  METHODS
  Children aged 1-13 years.
  
  
  METHODS
  ASA I patient who needed a diagnostic UGE; eligible, 36, participants, 30.
  
  
  METHODS
  historical cohort of patients who needed UGE (years 2008-2010): 50 patients.
  
  
  METHODS
  UGE performed with anaesthetic protocol, vital signs monitoring, sedation level (Ramsay scale) and BIS monitoring.
  
  
  METHODS
  propofol total dose (mg/kg), induction time, time in performing the UGE, awakening time (min); initial BIS (iBIS), and BIS during the UGE; adverse effects.
  
  
  RESULTS
  There were no significant differences in sex, age or weight between case (B) and control (C) population. No significant differences in total propofol doses: (B 4.9 ± 1.4 mg/kg; C 5.2 ± 1.6 mg/kg, P=.492), awakening time (B 12.2 ± 4.6 min; C 12.8 ± 4.4 min, P=.402), time for execution of UGE (B 9.5 ± 4.8 min; C 11.3 ± 6.5 min, P=.335) and induction time (B 11.1 ± 2.6 min; C 10.1 ± 4.2 min, P=.059), iBIS 55.4 ± 6.9. There were no significant differences in adverse effects: 2 patients suffered from mild desaturation in the control group.
  
  
  CONCLUSIONS
  BIS monitoring for diagnostic UGE in spontaneous breathing in a pediatric population is feasible, but does not appear to decrease awakening time or the amount of propofol needed. Furthermore, there was no statistically significant decrease in the number of adverse effects.
authors: Unidad de Cuidados Intensivos Pediátricos, Unidad de Gestión Clínica de Pediatría, Complejo Hospitalario de Jaén, Jaén, Spain. fjaladosarbol@hotmail.com
authors: F J
authors: FJ
authors: Alados-Arboledas
authors: M P
authors: MP
authors: Millán-Bueno
authors: J F
authors: JF
authors: Expósito-Montes
authors: C
authors: C
authors: Santiago-Gutierrez
authors: A
authors: A
authors: Arévalo-Garrido
authors: A
authors: A
authors: Pérez-Parras
authors: L
authors: L
authors: Millán-Miralles
authors: M C
authors: MC
authors: Martínez-Padilla
authors: J
authors: J
authors: de la Cruz-Moreno
mesh_terms: D000293:Adolescent; D000758:Anesthesia; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D056805:Consciousness Monitors; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007223:Infant; D016343:Monitoring, Intraoperative / Q000379:methods*; D011446:Prospective Studies; D012119:Respiration
keywords: Bispectral index; Endoscopia digestiva alta; Propofol; Respiración espontánea; Spontaneous breathing; Upper gastrointestinal endoscopy; Índice biespectral