Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;15(2):358-365.
doi: 10.5114/wiitm.2020.93461. Epub 2020 Mar 4.

Evaluation of bispectral index monitoring efficacy in endoscopic patients who underwent retrograde cholangiopancreatography and received sedoanalgesia

Ferda Yilmaz Inal  1 , Hayrettin Daskaya  2 , Yadigar Yilmaz  3 , Hasan Kocoglu  1
Affiliations

Evaluation of bispectral index monitoring efficacy in endoscopic patients who underwent retrograde cholangiopancreatography and received sedoanalgesia

Ferda Yilmaz Inal et al. Wideochir Inne Tech Maloinwazyjne. 2020 Jun.

Abstract

Introduction: Bispectral index (BIS) monitoring provides an objective, non-invasive measurement of the level of consciousness in a sedated patient.

Aim: In this prospective study, we aimed to investigate the hypothesis that risk of respiratory depression could be reduced and the desired level of sedation with minimal doses of propofol could be achieved by using BIS monitoring in endoscopic retrograde cholangiopancreatography (ERCP) procedures.

Material and methods: Sixty patients in the ASA 1-2 category, who were scheduled for an ERCP with sedation, were randomly divided into two groups. The procedure was performed, and sedation was administered so that the patient's Ramsay Sedation Score (RSS) would be 4-5 in the first group (group 1) and the patient's BIS value would be 65-75 in the second group (group 2). Cardiopulmonary complications, the total duration of the procedure, and the total amount of propofol administered were recorded.

Results: The mean SpO2 measurements at the third minute, fifth minute, and 10th minute were higher in the BIS group (p < 0.001) (p < 0.05). The mean number of respirations during the third, fifth, 10th, and 15th minute of sedation was significantly higher in the RSS group than in the BIS group (p < 0.05). There was no difference between the groups in terms of recovery time, total propofol amount, and additional doses of bolus propofol.

Conclusions: BIS monitoring during sedation with propofol for ERCP did not reduce total propofol use, but it may be an efficient guide for the timing of additional dose administration, which could reduce the risk of respiratory depression, and it could be used safely as an objective method in the follow-up of level of sedation.

Keywords: bispectral index; endoscopic retrograde cholangiopancreatography; sedation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of SpO2 values
Figure 2
Figure 2
Comparison of respiratory rates
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dumonceau JM, Riphaus A, Aparicio JR, et al. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy. Endoscopy. 2010;42:960–74. - PubMed
    1. Riphaus A, Wehrmann T, Weber B, et al. Sektion Enoskopie im Auftrag der Deutschen Gesellschaft für Verdauungs- und Stoffwechselerkrankungen e.V. (DGVS); Bundesverband Niedergelassener Gastroenterologen Deuschlands e. V. (Bng); Chirurgische Arbeitsgemeinschaft für Endoskopie und Sonographie der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV); Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung e. V. (DCCV); Deutsche Gesellschaft für Endoskopie Assistenzpersonal (DEGEA); Deutsche Gesellschaft für Anästhesie und Intensivmedizin (DGAI); Gesellschaft für Recht und Politik im Gesundheitswesen (GPRG). [S3-guidelines – Sedation in gastrointestinal endoscopy] Z Gastroenterol. 2008;46:1298–330. - PubMed
    1. Cohen LB, Delegge MH, Aisenberg J, et al. AGA Institute review of endoscopic sedation. Gastroenterology. 2007;133:675–701. - PubMed
    1. Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. Lichtenstein DR, Jagannath S, Baron TH, et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2008;68:815–26. - PubMed
    1. Soehle M, Ellerkmann RK, Grube M, et al. Comparison between bispectral index and patient state index as measures of the electroencephalographic effects of sevoflurane. Anesthesiology. 2008;109:799–805. - PubMed