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TECHNOLOGY, COMPUTING, AND SIMULATION

Bispectral-Index-Guided Versus Clinically Guided Remifentanil/Propofol Analgesia/Sedation for Interventional Radiological Procedures: An Observer-Blinded Randomized Study

Ashraf A. Dahaba, MD, MSc, PhD^*, Ulrike Lischnig, MD^*, Robert Kronthaler, MD^*, Helmar Bornemann, MD^*, Vassil Georgiev, MD^*, Peter H. Rehak, PhD, and Helfried Metzler, MD^*

From the *Department of Anaesthesiology and Intensive Care Medicine, and Biomedical Engineering and Computing Unit of the Department of Surgery, Graz Medical University, Graz, Austria.

Address correspondence and reprint requests to Ashraf A. Dahaba, MD, MSc, PhD, Department of Anaesthesiology and Intensive Care Medicine, Graz Medical University, Graz, Austria. Auenbruggerplatz 29, A-8036, Graz, Austria. Address e-mail to ashraf.dahaba{at}meduni-graz.at.

Patients undergoing potentially painful interventional radiological procedures generally require a combination of analgesia and sedation. This sedation/analgesia should allow the patient to communicate while also remaining calm. Bispectral index (BIS) monitoring could be useful in achieving this. The primary end-point of our study was to compare the percentage time with optimal sedation, defined as Sedation Agitation Scale (SAS) grade 4, between a BIS-guided remifentanil/propofol regimen and a clinically guided regimen in 54 randomly allocated patients. The mean ± sd percentage time with optimal sedation was significantly longer (P = 0.004) in the BIS group (76.6% ± 14.7%) than in the SAS group (63.8% ± 16.4%). There was a significant difference in the weighted mean infusion rates of remifentanil (P = 0.0067) and propofol (P = 0.0075) in the BIS group (0.066 ± 0.027 µg · kg^–1 · min^–1 1.59 ± 0.44 mg · kg^–1 · h^–1) compared with the SAS group (0.091 ± 0.036 µg · kg^–1 · min^–1 1.92 ± 0.43 mg · kg^–1 · h^–1), respectively. BIS values exhibited a temporal correlation to SAS scores (r² = 0.72). In conclusion, a BIS-guided regimen was more effective than a SAS-guided regimen. The use of BIS resulted in fewer remifentanil and propofol doses. The targeted BIS range of 80–85 provided a sufficient functional level of sedation.

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				Bispectral Index Monitoring Helps Achieve Optimal Sedation Journal Watch Emergency Medicine, August 25, 2006; 2006(825): 2 - 2. [Full Text]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999