Abstract
Purpose: The Bispectral Index (BIS) provides an estimate of depth of consciousness during sedation. If apnea can be shown to correlate with BIS, then a potential improvement in safety during MAC/sedation may be achieved. Scope: Ninety-nine patients undergoing MAC anesthesia were monitored with BIS for level of consciousness, and capnography for apnea detection. The anesthesia provider was blinded to BIS and capnography data. Forty-nine percent of subjects experienced apnea independent of medical history, procedure, or medication. BIS immediately preceding apneic episodes (55 ± 18) was frequently lower than that recommended for an upper limit during general anesthetics (<60). The incidence increased as depth of consciousness decreased with a 50% likelihood of developing apnea at a BIS of 56. Conclusions: The incidence of apnea during MAC is high, and incidence increases as BIS decreases.
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