Monitorowanie indeksu bispektralnego w celu optymalnego doboru wziewnego środka anestetycznego do operacji laminotomii lędźwiowej

*Danuta Skaja¹, Mariusz Graff¹, Zbigniew Karwacki¹, Piotr Zieliński², Przemysław Kowiański³, Paweł Słoniewski²

Summary
Background.Awareness during anaesthesia due to inadequate dosing and/or increased demand for anaesthetic agents has been reported by various authors. We have assessed the usefulness of BIS monitoring during sevoflurane, isoflurane, or desflurane anaesthesia for lumbar laminotomy.
Methods. 60 adult patients were randomly divided to receive sevoflurane, isoflurane, or desflurane with nitrous oxide, fentanyl and vecuronium. The end-tidal concentration of halogenated agents was adjusted to maintain BIS between 40 and 60.
Results. The end-tidal concentration of volatile agents, necessary to maintain the BIS reading between 40 and 60 was 1.8% sevoflurane, 0.8% isoflurane, and 3.55% desflurane. The highest blood pressure and heart rate values were noted before anaesthesia and before extubation. The mean recovery time was similar in the isoflurane and sevoflurane groups: 8.2±2.3 min and 8.8±3.2 min respectively, but it was significantly shorter in the desflurane group (4.8±1.8 min). No awareness episodes were observed.
Discussion and conclusion. The results indicate that BIS monitoring allows for precise adjustment of the concentration of volatile agents and effectively prevents awareness. Patients wake faster from general anaesthesia maintained with desflurane when compared with sevoflurane and isoflurane.

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