Table 7: Summary of Findings From Studies Reporting on the Effectiveness of BIS Monitors To Reduce Recovery Time*.
| Study (year) |
Kreuer et al. (2003) (25) |
Ahmad et al. (2003) (39) |
Recart et al. (2003) (27) |
Puri and Murphy (2003) (28) |
|---|---|---|---|---|
| Study type | RCT Group1: Narcotrend Group 2: BIS Group 3: SP |
RCT Group 1: BIS Group 2: SP |
RCT Group1: BIS Group 2: AEP Group 3: SP |
RCT Group 1: BIS Group 2: SP |
| Level of evidence | 1 | 1 | 1 | 1 |
| Study population | Adult patients scheduled to have minor orthopedic surgery expected to last at least 1 hour | Patients undergoing gynecologic laparoscopy | Healthy patients undergoing laparoscopic general surgery | Patients undergoing valve replacement or coronary artery grafting under cardiopulmonary bypass |
| Number of patients | 120 (40 in each group; equal number of males and females) | 97 (49 BIS; 48 SP) | 90 | 30 adult patients undergoing valve replacement or coronary artery bypass grafting |
| Mean age, years (SD) | BIS: 43.8 (4.2) SP: 46.1 (4.5) |
BIS: 35.6 (8.7) SP: 35.4 (8.9) |
BIS: 47 (17) AEP: 42 (14) SP: 46 (15) |
BIS: 38.2 (14.0) SP: 32.1 (13.8) |
| Premedication | Yes | No | Yes | Midazolam and morphine |
| Anesthetic technique | Propofol and remifentanil | Sufentanil and sevoflurane | Propofol, fentanyl, and desflurane | Morphine, midazolam, thiopental, isoflurane, and nitrous oxide |
| Tracheal intubation | Yes | Yes | Yes | Yes |
| BIS values | Targeted BIS: 50 | Targeted BIS: 50–60 | BIS: Mean, 49 (SD, 13) SP: Mean, 40 (SD, 11) |
End of bypass: BIS: Mean, 49.7 (SD, 6) SP: Mean, 56.4 (SD, 25) |
| Recovery time | Time to eye opening, extubation, and arriving to PACU decreased significantly with the use of BIS (P <.001). In the SP group, recovery times were significantly shorter for women than for men (P = .003). In the BIS group, females and males had similar recovery times. |
The number of patients who successfully passed phase 1 recovery area was not different: BIS group: 42 (86%) SP group: 43 (90%) The mean length of stay (minutes) in the phase-2 recovery area before discharge did not differ between groups: BIS: 203 (SD, 78) SP: 200 (SD, 74) |
Extubation time was calculated as the number of minutes from stopping desflurane until the tracheal tube was removed. Extubation time: BIS: 6 (4) SP: 11 (10) (P<.05) PACU stay (minutes): BIS: 80 (47) SP: 108 (58) (P<.05) Following commands: no significant differences between groups Postoperative pain and request for analgesia: no differences between groups |
The time to recovery was defined as the time from turning off the anesthetic vaporizer to the time that a patient opened his/her eyes and obeyed a spoken command. There were no differences in the time to reach the recovery endpoint or the time to tracheal extubation between the 2 groups. |