Mitra Golmohammadi , Mehdi Abasgholizadeh ,
Volume 72, Issue 7 (10-2014)
Abstract
Background: Morbid obesity is associated with a some of significant comorbidities. Early and uneventful postoperative recovery of obese patients remains a challenge for anesthesiologists. It seems Bispecteral Index (BIS) monitoring may reduce drug usage and hasten recovery time in inhalation anesthesia. The aim of this study was to investigate the effect of BIS monitoring on intraoperative isoflurane utilization and the early recovery profile.
Methods: Fifty morbidly obese adult patients (Body Mass Index (BMI) of 35 kg/m2 or grater) undergoing elective laparoscopic cholecystectomy in Urmia Imam Khomeini Hospital were enrolled in this prospective, Cohort and single blind study. Duration of this study was six months between April to September 2012. Patients were randomly divided two groups (25 patients per group). In the first phase of the study, patients were anesthetized without the use of BIS monitoring and isoflurane being administered according to standard clinical practice (this group formed the control group). In a second phase, with use of BIS monitoring isoflurane was titrated to maintain a BIS value between 40 and 60 during surgery, and then 60-70 during 15 min before the end of surgery (this group formed the BIS group). Isoflurane consumption and recovery time were compared between two groups.
Results: All patients completed the study. No differences were noted between demographic data. The isoflurane consumption in the BIS group was 30-35% lower than in the control group (P< 0.001). The time to awakening and duration of extubation in the BIS group were significantly less than the control group (P< 0.001). Furthermore, analgesic consumption in the recovery room and sedation score during postoperative phase were similar between the groups. Significant differences were noted in recovery time between two groups (P< 0.001).
Conclusion: The addition of Bispectral index monitoring to standard monitoring reduced isoflurane usage. We found use of BIS hastened recovery time after isoflurane anesthesia.
Omid Moradi Moghaddam, Mohammad Niyakan Lahiji , Valiollah Hassani , Farid Kazemi Gezik, Ehsan Farazi ,
Volume 73, Issue 2 (5-2015)
Abstract
Background: Bispectral Index (BIS) may be used in traumatic brain injured patients with different anatomical sites of injury to evaluate the level of consciousness. The objective of this study is to evaluate the relation between type of brain injury and the presence or absence of frontal lobe damage based on brain CT-scan with BIS monitoring in intubated acute head trauma patients admitted to the intensive care unit (ICU).
Methods: Participants of this cross-sectional study consisted of 30 intubated head trauma patients over the age of 15 years old, without any known history of visual or hearing impairments, neurologic disorders, mental retardation, or frontal skin laceration, who were admitted to the ICU in Rasool Akram University Hospital, Tehran. Patients who needed muscle relaxant administration, or those who showed instability of vital signs, hypoxemia, disorders of the blood biochemistry, or blood gases, liver or kidney failure, convulsion or hypoxic encephalopathy during the study were excluded. In the first three days of admission, each patient underwent monitoring of BIS every sixty minutes for just six hours a day. All the hypnotic drugs were discontinued six hours prior to the start of monitoring and fentanyl was the only opioid, which was administered if an analgesic was required. Statistical analysis were used to evaluate the data and p-value less than 0.05 was considered statistically significant.
Results: Mean age of all patients was 43.6 years with a Standard Deviation (SD) of 18.96. Presence or absence of frontal lobe injury, had no statistically significant correlations with mean BIS in each three days of study and the mean BIS total. However, mean BIS in the second and third days had statistically significant differences in different types of cranial lesions (contusion, subdural hemorrhage, subarachnoid hemorrhage, etc) which usually have different prognoses.
Conclusion: Different kinds of acute traumatic cranial lesions with different prognosis may have different values in BIS monitoring. Presence or absence of frontal lobe injury, had no statistically significant correlations with BIS values.
