Korean J Anesthesiol.  2003 Mar;44(3):370-375. 10.4097/kjae.2003.44.3.370.

The Usefulness of the Bispectral Index during Propofol and Fentanyl Anesthesia for Coronary Bypass Surgery under Cardiopulmonary Bypass

• Kim SC
• Kim CS
• Cho HS
• Lee SM

• KMID: 2299014
• DOI: http://doi.org/10.4097/kjae.2003.44.3.370

Abstract

BACKGROUND: The incidence of intraoperative awareness is known to be high in cardiac surgery using cardiopulmaonary bypass, and there is a tendency to use more anesthetics to maintain anesthesia without recall. We investigated the usefulness of the bispectral index monitor in reducing the amount of anesthetics without intraoperative awareness.
METHODS
Forty patients scheduled for elective coronary artery bypass graft surgery under cardiopulmonary bypass were randomly allocated into two groups. In the control group, systemic blood pressure was a main indicator to contol the infusion rate of propofol and fentanyl. Infusion rate of propofol and fentanyl were controlled by the bispectral index in the BIS group. A post- anesthetic interview relating to intraoperative awareness was performed on the second postoperative day by a research assistant.
RESULTS
The average flow rate of propofol (control group; 0.137+/-0.012 mg/kg/min, BIS group; 0.110+/-0.003 mg/kg/min, P<0.01) and fentanyl (control group; 6.485+/-0.413mug/kg/h, BIS group; 4.321+/-0.5mug/kg/h, P<0.01) were significantly different between groups. The postoperative extubation time was 6.8+/-1.9 h in the control group and 5.3+/-2.3 h in the BIS group (P<0.05). The average BIS was 43.1+/-5.6. No subjects showed positive results in the intraoperative awareness test.
CONCLUSIONS
Intraoperative monitoring of the bispectral index in patients undergoing cardiopulmonary bypass for coronary bypass surgery reduced requirement of anesthetics without intraoperative awareness.

Keyword

Intraoperative awareness; bispectral index; cardiac surgery; cardiopulmonary bypass; propofol; fentanyl

MeSH Terms

Anesthesia*
Anesthetics
Blood Pressure
Cardiopulmonary Bypass*
Consciousness Monitors
Coronary Artery Bypass
Fentanyl*
Humans
Incidence
Intraoperative Awareness
Monitoring, Intraoperative
Propofol*
Thoracic Surgery
Transplants
Anesthetics
Fentanyl
Propofol