Reduction in anaesthetic drug consumption is correlated with mean titrated intra-operative Bispectral Index values

Authors: Ellerkmann; Kreuer¹; Wilhelm²; Röpcke³; Hoeft⁴; Bruhn⁵

Source: Acta Anaesthesiologica Scandinavica, Volume 50, Number 10, November 2006 , pp. 1244-1249(6)

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Abstract:

Background:

Several studies have shown a reduction in anaesthetic drug consumption with Bispectral Index (BIS) titration compared with standard clinical practice. However, the amount of reduction varied widely between 1% and 40%. We investigated the correlation between reduction in anaesthetic drug consumption and mean titrated BIS values. Methods:

An analysis upon randomized controlled trials cited until January 2006 in MEDLINE and other databases investigating the potential reduction in anaesthetic (hypnotic) drug consumption with BIS titration was performed. Investigations with a marked difference (> 15%) in opioid drug consumption between the BIS group and the standard practice group were excluded. Correlations between amount of reduction in hypnotic drug use and the mean titrated BIS value were analysed with linear regression. Results:

Fourteen manuscripts covering 2582 patients were included into the analysis. The mean BIS value in the standard clinical practice group averaged over all studies was 43.6 ± 3.2 and the mean BIS value in the BIS-titrated group was 49.9 ± 5.4. The amount of reduction in hypnotic drug use correlated significantly with the mean BIS values in the BIS-titrated groups (r =0.68) and with the differences between the mean BIS value in the BIS-titrated group and the mean BIS value in the standard clinical practice group (r = 0.70). Every point of BIS difference between the two groups resulted in a reduced hypnotic drug use of approximately 2%. Conclusion:

Despite differences in the study designs and in the drugs used, a linear correlation between the mean titrated BIS value and the hypnotic drug saving potential was found.

Keywords: Bispectral Index; EEG monitoring; reduction in hypnotic drug consumption; anesthesia

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1399-6576.2006.01146.x

Affiliations: 1: University of Saarland, Homburg/Saar, Saarland 2: St.-Marien-Hospital, Lünen 3: Städtische Kliniken Mönchengladbach, Mönchengladbach, Germany 4: University of Bonn, Bonn 5: Department of Anesthesiology, UMC St. Radboud, Nijmegen, The Netherlands

Publication date: 2006-11-01

Reduction in anaesthetic drug consumption is correlated with mean titrated intra-operative Bispectral Index values

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