Does Perioperative Bispectral Index Monitoring Decrease Time To Extubation In Patients Undergoing Coronary Artery Bypass Graft Procedures?

Abstract

In a prospective randomized study the Bispectral index (BIS) was used to titrate propofol infusion during cardiopulmonary bypass (CPB) (between 40-50) and in the postoperative period in the ICU ( between 60-70) until extubation. We studied a total of 40 patients undergoing cardiac surgery under CPB. They were randomized to 20 patients each in the BIS and standard therapy group (STG). In the STG group the propofol infusion was titrated to mean arterial pressures (MAPS) of 55 to 65 mm Hg during CPB and to a sedation score of zero on the Sedation-Agitation Scale (SAS). Patients in both groups had similar demographic characteristics, duration of CPB and surgery. The total amount of propofol used (BIS 1662mg, STG 1729 mg)] showed no statistical difference despite BIS monitoring. The time to the average time to eye opening (190 min), time to wean (210 min) and extubation (BIS 352 minutes, STG 380 minutes) were comparable in the both groups. Monitoring of hypnotic component with BIS during cardiac surgery failed to demonstrate an earlier time to recovery and extubation.