BISPECTRAL INDEX MONITORING REDUCED THE FENTANYL CONSUMPTION IN CORONARY ARTERY BYPASS GRAGT SURGERY
Department of anesthesiology, Medical College, Pochun
University, Pochun, Korea *Pundang
CHA General Hospital
Aim
Usually, in open heart surgery, induction
and maintain dose of fentanyl is determined by hemodynamic variables. We
compared the amount of fentanyl, hemodynamics, awakening and extubation time to
evaluate the usefulness of bispectral index(BIS) during coronary artery bypass
graft surgery(CABG).
Method
Twenty patients, who had good LV function
(EF>50%), were participated with IRB approval. BIS group was studied
prospectively and control group (without BIS) was reviewed with anesthetic
record. In control group (n=10), fentanyl was given to keep vital sign stable
under hemodynamic monitoring only. In BIS group (n=10), fentanyl was restricted
under 50 BIS level, if vital sign was stable, and maintained between 40-60 BIS
level during the operation. We also evaluated the time of eye opening on verbal
command and extubation.
Results
There were no differences between two
groups, in demographic data, hemodynamic variables, LV function, duration of
operation, amount of sedatives. The induction and total dose of fentanyl were
smaller in BIS group (19.3±3.7 μg/kg, 2730±257.3 μg) than control
group (46.1±9.3 μg/kg, 5090±128.5 μg) significantly (p=0.0012, p=0.007).
Although 60% of BIS group opened eyes on verbal command at the end of
operation, none in the control group. Extubation time was shorter in BIS
group(p=0.003).
Conclusion
BIS monitoring reduces the amount of
fentanyl in CABG operation. It makes the patients wake up earlier and have
shorter intubation period.