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. 2022 Jul;55(4):558-563.
doi: 10.5946/ce.2022.001. Epub 2022 Jul 12.

Bispectral index-guided propofol sedation during endoscopic ultrasonography

Ayana Okamoto  1 , Ken Kamata  1 , Takeshi Miyata  1 , Tomoe Yoshikawa  1 , Rei Ishikawa  1 , Tomohiro Yamazaki  1 , Atsushi Nakai  1 , Shunsuke Omoto  1 , Kosuke Minaga  1 , Kentaro Yamao  1 , Mamoru Takenaka  1 , Yasutaka Chiba  2 , Toshiharu Sakurai  1 , Naoshi Nishida  1 , Masayuki Kitano  3 , Masatoshi Kudo  1
Affiliations

Bispectral index-guided propofol sedation during endoscopic ultrasonography

Ayana Okamoto et al. Clin Endosc. 2022 Jul.

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).

Conclusion: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.

Keywords: Consciousness monitors; Endosonography; Intravenous anesthesia; Midazolam; Propofol.

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Conflict of interest statement

Conflicts of Interest

The authors have no potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.
The bispectral index monitor analyzes the brain waves and displays the calculated bispectral index value at the bottom of the screen.
See this image and copyright information in PMC

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