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Framed Question: Bispectral Index Evidence
ID: 204070     
ISSN #: 1365-2044 (Electronic)
Publication Type: Clinical Trial
Title: A study to assess the value of bispectral analysis in intravenous sedation with midazolam during third molar surgery under local anaesthesia.
Authors: Cheung CW
Irwin MG
Chiu WK
Ying CL
Source: Anaesthesia. 2008 Dec;63(12):1302-8.
Acronym:
MeSH: Adult
Anesthesia Recovery Period
Anesthesia, Dental/methods
Anesthesia, Local
Conscious Sedation/*methods
Drug Administration Schedule
Electroencephalography/*drug effects
Female
Humans
Hypnotics and Sedatives/*administration & dosage/pharmacology
Male
Mental Recall/drug effects
Midazolam/*administration & dosage/pharmacology
Molar, Third/*surgery
Monitoring, Intraoperative/methods
Tooth Extraction
Young Adult
Abstract: SUMMARY: This study aimed to determine whether bispectral index (BIS) can be used as an indicator of sedation and recovery with intravenous midazolam. In Part A, 30 healthy patients undergoing third molar extraction under local anaesthesia were recruited. They were sedated with intravenous midazolam titrated to clinical endpoints. BIS values were recorded when adequately sedated (BIS(S)) and when clinical recovery criteria were met (BIS). In Part B, another 30 patients were sedated to the range of BIS(S) obtained in Part A. Recovery was assessed postoperatively when the range of BIS(R) from Part A was reached. BIS titrated patients required less midazolam (p < 0.001). Seventy percent of Part B patients required increments of midazolam during surgery, compared to 16.7% in Part A (p < 0.001). Total dose of midazolam given was lower in Part B (p = 0.025). BIS is not effective as a sole indicator of endpoint in sedation with intravenous midazolam.
Country: England
Language: eng
Institution: Department of Anaesthesiology, The University of Hong Kong, Hong Kong. cheucw@hku.hk
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