Application of Bispectral index (BIS) to guide the etomidate target-controlled infusion during painless colonoscopy in the old patients

Abstract

Objective To observe the differences of Bispectral index (BIS) in different age of old patients to guide the etomidate target-controlled infusion during painless colonoscopy. Methods Two groups of forty old patients of 60 to 74 and 75 to 90 years old were randomly divided into two subgroups, Y1 and Y2 group, O1 and O2 group. Guidance with BIS controlled the etomidate target-controlled infusion rates at 65-85 or 40-65. The vital signs, adverse reactions and patient's satisfaction degree after operation were recorded. Results The rate of MAP fluctuation in group Y1 was more than that in group Y2 or group O1 (P<0.05) , and had the tendency to rise. The accidental awake or intraoperative awareness in group Y1 was obviously more than that in the other three groups (P<0.01) .The accidental awake or intraoperative awareness in group O1 was more than that in group Y2 or group O2 (P<0.05) .The rate of HR fluctuation and the percentage of the patients who were not satisfied with anesthesia in group Y1 was more than those in the other three groups (P<0.05) . The rate of MAP fluctuation in group O2 was more than that in group Y2 or group O1 (P<0.05) .The rate of respiratory inhibition in group Y1 was more than that in the other three groups (P<0.05) . The total etomidate dosage used in group Y1 or Y2 was more than that in group O1 or O2 (P<0.05) . The patient's revival time and staying time in group O2 were more than those in the other three groups (P<0.05) . Conclusion The anesthesia depth is different in different age of elderly patients during painless colonoscopy with etomidate, BIS value 65-85 can meet the need of painless colonoscopy for 75 years old or older ones, and BIS 40-65 for 60-74 years old. Key words: Bispectral index; Etomidate; Target-controlled infusion; Old age; Painless colonoscopy