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AMBULATORY ANESTHESIA

The Effect of Noise on the Bispectral Index During Propofol Sedation

Dae Woo Kim, MD PhD^*, Ho Yeong Kil, MD PhD, and Paul F. White, PhD MD, FANZCA

*Department of Anesthesiology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Anesthesiology, School of Medicine, Hallym University, Seoul, Korea; Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas

Address correspondence to Paul F. White, PhD, MD, FANZCA, Department of Anesthesiology & Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, F2.208, Dallas, TX 75390-9068. Address e-mail to paul.white{at}utsouthwestern.edu

Because noise in the operating room has been alleged to interfere with the ability to sedate patients before surgery, we evaluated the effect of noise on the Bispectral index (BIS) value during propofol sedation. Thirty unpremedicated patients were studied before the start of surgery while receiving propofol sedation on two separate occasions according to a randomized, crossover protocol design. After achieving a stable baseline BIS value of either 75 or 80 with a target-controlled infusion of propofol, an external sound source administered noise at 50, 80, 110, and 120 dB. The changes in the BIS value were recorded over a 1-min interval at each noise level. In the BIS 75 group, increasing levels of noise did not significantly alter the BIS value. However, in the BIS 80 group, the BIS values at 80, 110, and 120 dB were significantly higher compared to the value at 50 dB. In conclusion, experimental noise increases the BIS and appears to have a greater effect on the BIS value at "lighter" levels of propofol sedation.

IMPLICATIONS: Experimental noise levels can increase the Bispectral index (BIS) values during propofol sedation in the operating room. However, the magnitude of the BIS response is influenced by the depth of sedation.

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