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. 2022 Nov 10:13:1028582.
doi: 10.3389/fneur.2022.1028582. eCollection 2022.

Effect of bispectral index-guided total intravenous anesthesia in younger children: A prospective, randomized, controlled trial

Guoliang Liu  1 , Jianmin Zhang  1 , Fang Wang  1 , Lijing Li  1 , Xuemei Zhang  1
Affiliations

Effect of bispectral index-guided total intravenous anesthesia in younger children: A prospective, randomized, controlled trial

Guoliang Liu et al. Front Neurol. .

Abstract

Background: BIS-guided total intravenous anesthesia (TIVA) is widely used in children, but few studies have attempted to evaluation of the effect of BIS-guided TIVA in younger children. This study aimed to evaluate the effect of bispectral index (BIS) guidance during TIVA in younger children during anesthesia.

Methods: This study is a prospective, randomized, single-blind and controlled clinical trial. This study enrolled pediatric patients (aged 1-3 years) who were scheduled for surgery under TIVA with propofol and remifentanil. The children were randomly assigned to the BIS group (group B) and standard clinical practice group (group S). The BIS values in group B were maintained at 45-60. The anesthesiologist controlled the depth of anesthesia in group S according to the variation in the clinical signs of the children. The time of extubation, duration of stay in post-anesthesia care unit (PACU), as well as BIS values, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation at eight time points 1 min before induction (T1), 1 min after induction (1 min after the induction drugs were administrated) (T2), immediately after intubation (T3), immediately after skin incision (T4), 30 min after the start of the operation (T5), 60 min after the start of operation (T6), immediately after drug withdrawal (T7), and immediately after extubation (T8), propofol consumption, and postoperative adverse reactions were recorded.

Results: There was no significant difference in time to extubation 15(10,21) vs 14 (11,20) and duration of stay in PACU 27 (20,37) vs. 29 (22,39) between the group B and group S. At the time points 30 min after the start of the operation, 60 min after the start of operation and immediately after drug withdrawal, the BIS values in group S were significantly higher than those in group B (57 ± 9, 57 ± 9, 60 ± 8 vs 52 ± 7, 54 ± 7, 57 ± 6).

Conclusions: The use of BIS-guided total intravenous anesthesia in younger children does not shorten the time of extubation and the duration of stay in the PACU.

Trial registration: Chictr.org.cn identifier: 24/11/2017, ChiCTR-IOR-17013530.

Keywords: bispectral index; propfol; recovery; total intravenous anesthesia; younger children.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewers CW and YS declared a shared parent affiliation with the authors to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Flowchart showing the process of enrollment of all children.
Figure 2
Figure 2
Changes in bispectral index (BIS) values at each time point in the two groups. BIS values significantly differed among the eight time points as well as between the two groups (P < 0.05). At the time points 30 min after the start of the operation, 60 min after the start of operation and immediately after drug withdrawal, the BIS values in group S were significantly higher than those in group B (P < 0.05).
Figure 3
Figure 3
Changes in heart rates at each time point in the two groups. The HR values significantly differed among the eight time points (P < 0.05). There was no significantly difference in HR values between the two groups (P > 0.05).
Figure 4
Figure 4
Mean arterial pressure (MAP) changes in the two groups. The MAP values significantly differed among the eight time points as well as between the two groups (P < 0.05). MAP in group B was lower than in group S at 30 min after the start of the operation, 60 min after the start of operation, immediately after drug withdrawal, and immediately after extubation (P < 0.05).
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