Evaluation of the compliance between EEG monitoring (Bispectral IndexTM) and Ramsey Sedation Scale to measure the depth of sedation in the patients who underwent procedural sedation and analgesia in the emergency department.

Abstract

This study aimed to investigate the compliance between electroencephalogram monitoring (Bispectral Index, BIS) and Ramsay Sedation Scale (RSS) to measure the depth of sedation in patients who underwent procedural sedation and analgesia (PSA) in an emergency department. This study also aimed to investigate the usefulness of this compliance for early diagnosis of complications. A total of 54 consecutive patients during PSA in the emergency department were included in this study. The BIS and RSS scores at regular intervals and also all complications and interventions of these patients were evaluated. The compliance between the BIS and the RSS score was evaluated. The BIS scores of cases with complication and without complication were compared. The BIS and RSS scores exhibited a high correlation was detected between the average BIS and RSS scores at each time interval (r=-0.989, p<0.001). The BIS scores of the complicated and uncomplicated cases were different at 15 min after the procedure (p=0.019). The cases were divided into two groups according to the BIS scores <70 and ≥70; complication rates were higher in the BIS score <70 group during the procedure (p=0.037). In our study, a high correlation was detected between BIS monitoring and RSS scores. BIS monitoring for PSA can be used as a full-time, objective, and an alternative technique for person-dependent clinical scales and also as an indicator for early diagnosis of complications.