title: Efficacy of bispectral index monitoring during balanced propofol sedation for colonoscopy: a prospective, randomized controlled trial.
abstract: OBJECTIVE
  Appropriate use of propofol is necessary, and objective monitoring of sedation with propofol may be helpful. Studies on the efficacy of bispectral index (BIS) monitoring in deep sedation have been conducted, but its efficacy in colonoscopy with moderate sedation is unknown. In this study, the efficacy of BIS monitoring during colonoscopy with moderate level sedation via balanced propofol sedation was investigated.
  
  
  METHODS
  To determine the cut-off value of BIS before the test, an optimal BIS value was determined. Patients who were scheduled to undergo outpatient colonoscopy were prospectively randomized to either a BIS or control group. Finally, a total of 115 patients were selected for this study. The satisfaction level, the complication, and the dosage of the administered propofol were compared.
  
  
  RESULTS
  The BIS values and the modified observer's assessment of alertness/sedation scores (MOAA/S) were positively correlated (r=0.66 and p<0.001). The optimal cut-off value of BIS for maintaining moderate sedation was 81, and the area under the ROC curve was 0.88 (95% CI 0.82-0.93), indicating high prediction accuracy. However, there was no difference between the BIS group and the control group in levels of satisfaction of either patients or endoscopists. In addition, there was no difference in the complication and the required dose of propofol between both groups.
  
  
  CONCLUSIONS
  BIS and clinical sedation scores, MOAA/S scores, showed a high level of correlation. However, no significant efficacy was observed in the BIS group who underwent outpatient colonoscopy.
authors: Department of Internal Medicine, Seoul Metropolitan Dongbu Hospital, Seoul, Korea.
authors: Yeon Hwa
authors: YH
authors: Yu
authors: Dong Soo
authors: DS
authors: Han
authors: Hyun Soo
authors: HS
authors: Kim
authors: Eun Kyung
authors: EK
authors: Kim
authors: Chang Soo
authors: CS
authors: Eun
authors: Kyo-Sang
authors: KS
authors: Yoo
authors: Woo Jong
authors: WJ
authors: Shin
authors: Seungho
authors: S
authors: Ryu
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003113:Colonoscopy; D016292:Procedural Sedation / Q000379:methods*; D056805:Consciousness Monitors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
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