Bispectral index-guided propofol sedation during endoscopic ultrasonography
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth ofanesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods: This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was usedin 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatorydepression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours afterleaving the endoscopy room. Results: The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg;p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in thenon-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than inthe non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients75 years of age or older.
Abstract
Background/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth ofanesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods: This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was usedin 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatorydepression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours afterleaving the endoscopy room. Results: The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg;p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in thenon-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than inthe non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients75 years of age or older.
참고문헌 (20)
- Kamata K, "Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions", Dig Endosc, 30, pp.98~106 (2018)
- Kamata K, "Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of submucosal tumors of the upper gastrointestinal tract", J Gastroenterol Hepatol, 32, pp.1686~1692 (2017)
- Cheriyan DG, "Propofol use in endoscopic retrograde cholangiopancreatography and endoscopic ultrasound", World J Gastroenterol, 20, pp.5171~5176 (2014)
- Amornyotin S, "Age-dependent safety analysis of propofol-based deep sedation for ERCP and EUS procedures at an endoscopy training center in a developing country", Clin Exp Gastroenterol, 5, pp.123~128 (2012)
- Lee TH, "Balanced propofol sedation versus propofol monosedation in therapeutic pancreaticobiliary endoscopic procedures", Dig Dis Sci, 57, pp.2113~2121 (2012)
- Pagano N, "Balanced propofol sedation in patients undergoing EUS-FNA : a pilot study to assess feasibility and safety", Diagn Ther Endosc, 2011, pp.542159~ (2011)
- YusoffIF, "Endoscopist administered propofol for upper-GI EUS is safe and effective : a prospective study in 500 patients", Gastrointest Endosc, 60, pp.356~360 (2004)
- Rampil IJ, "A primer for EEG signal processing in anesthesia", Anesthesiology, 89, pp.980~1002 (1998)
- Glass PS, "Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers", Anesthesiology, 86, pp.836~847 (1997)
- Aldrete JA, "A postanesthetic recovery score", Anesth Analg, 49, pp.924~934 (1970)
- Lovett P, "Propofol versus midazolam", fentanyl sedation for colonoscopy in the elderly patient population, 2017, pp.32, 210~214
- Schmitz A, "Sedation for magnetic resonance imaging using propofol with or without ketamine at induction in pediatrics : a prospective randomized double-blinded study", Paediatr Anaesth, 28, pp.264~274 (2018)
- Avidan MS, "Anesthesia awareness and the bispectral index", N Engl J Med, 358, pp.1097~1108 (2008)
- O’Connor MF, "BIS monitoring to prevent awareness during general anesthesia", Anesthesiology, 94, pp.520~522 (2001)
- Gan TJ, "Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group", Anesthesiology, 87, pp.808~815 (1997)
- Won Joon Choi, "How do you use bispectral index effectively for preventing re-awareness during general anesthesia?", Korean Journal of Anesthesiology, 62(1), pp.1~2 (2012), 대한마취통증의학회
- Sandler NA, "Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis", J Oral Maxillofac Surg, 59, pp.603~611 (2001)
- Jang SY, "Bispectral index monitoring as an adjunct to nurse-administered combined sedation during endoscopic retrograde cholangiopancreatography", World J Gastroenterol, 18, pp.6284~6289 (2012)
- von Delius S, "Bispectral index monitoring of midazolam and propofol sedation during endoscopic retrograde cholangiopancreatography : a randomized clinical trial(the EndoBIS study)", Endoscopy, 44, pp.258~264 (2012)
- Paspatis GA, "Efficacy of bispectral index monitoring as an adjunct to propofol deep sedation for ERCP : a randomized controlled trial", Endoscopy, 41, pp.1046~1051 (2009)