A randomized trial of propofol consumption and recovery profile with BIS‐guided anesthesia compared to standard practice in children

Abstract

To evaluate the impact of bispectral index (BIS) monitoring on the consumption of propofol and recovery from anesthesia compared to the standard clinical practice in children. Titrating propofol administration using BIS reduces its requirement and shortens the recovery from anesthesia in adults. However, there is still mixed evidence for utility of anesthesia depth monitors in reducing anesthesia requirement in children. A prospective randomized study was conducted in 50 ASA I children of 2-12 years, randomly assigned into standard practice (SP) or BIS group. After induction with propofol, anesthesia was maintained with 150 microg x kg(-1) x min(-1) propofol infusion. The propofol infusion rate was altered by 20 microg x kg(-1) x min(-1) to maintain the systolic blood pressure within 20% of the baseline (SP group) or BIS value between 45 and 60 (BIS group). The rate of propofol infusion was reduced by 50% about 15 min before the end of surgery. The amount of propofol used and the times from stopping the propofol infusion to eye opening, extubation, response to commands and attaining Steward score of 6 were recorded. There was no evidence of a difference in the mean propofol consumption in the two groups (BIS 232.6 +/- 136.7 mg, SP 250.8 +/- 118.2 mg). The intraoperative hemodynamics and BIS values were similar in the two groups. There was no evidence for a difference between groups in the mean times from termination of anesthetic to eye opening, extubation, response to commands and to achieve a Steward Recovery score of 6. Our study showed no benefit of BIS-guided propofol administration on anesthetic consumption or recovery compared to standard anesthetic practice.