Clin Endosc.  2022 Jul;55(4):558-563. 10.5946/ce.2022.001.

Bispectral index-guided propofol sedation during endoscopic ultrasonography

• Okamoto A
• Kamata K
• Miyata T
• Yoshikawa T
• Ishikawa R
• Yamazaki T
• Nakai A
• Omoto S
• Minaga K
• Yamao K
• Takenaka M
• Chiba Y
• Sakurai T
• Nishida N
• Kitano M
• Kudo M

• KMID: 2531950
• DOI: http://doi.org/10.5946/ce.2022.001

Abstract

Background/Aims
Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS).
Methods
This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room.
Results
The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001).
Conclusions
During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.

Keyword

Consciousness monitors; Endosonography; Midazolam; Propofol

Figure

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  Fig. 1. The bispectral index monitor analyzes the brain waves and displays the calculated bispectral index value at the bottom of the screen.

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