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Related Experiment Videos

[Bispectral index and desflurane concentration below 1 MAC].

M Wrobel1, S Kreuer, W Wilhelm

  • 1Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes. marc.wrobel@uniklinik-saarland.de

Der Anaesthesist
|January 30, 2004
PubMed
Summary

This study reveals a clear correlation between the bispectral index (BIS) and end-tidal desflurane concentrations during anesthesia. A BIS range of 40-49 indicates approximately 0.5 MAC of desflurane, crucial for fast-track anesthesia.

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Area of Science:

  • Anesthesiology
  • Neurophysiology
  • Pharmacology

Background:

  • Investigating the relationship between Bispectral Index (BIS) and end-tidal desflurane concentrations below 1 Minimum Alveolar Concentration (MAC).
  • Focusing on the clinical relevance of this relationship in fast-track anesthesia, particularly when desflurane is combined with remifentanil.
  • Utilizing the A-2000 BIS monitor (Aspect Medical Systems, USA) for accurate depth of anesthesia monitoring.

Purpose of the Study:

  • To establish a quantitative relationship between BIS values and end-tidal desflurane concentrations in adult patients undergoing minor orthopedic surgery.
  • To determine the desflurane concentration associated with specific BIS ranges, especially in the lower MAC range relevant for combined anesthesia techniques.
  • To evaluate the correlation during both intraoperative maintenance and emergence phases of anesthesia.

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Main Methods:

  • Studied 50 adult ASA I-III patients receiving desflurane-remifentanil anesthesia.
  • Recorded 1,483 pairs of end-tidal desflurane concentrations and corresponding BIS values.
  • Analyzed data using linear regression intraoperatively and non-linear regression during emergence.

Main Results:

  • A significant relationship was found between BIS ranges and mean end-tidal desflurane concentrations (P<0.05).
  • BIS ranges of 40-49 correlated with approximately 3.1 vol% (around 0.5 MAC) of desflurane.
  • Intraoperative correlation coefficient was R=0.42±0.24, while during emergence, it improved to R=0.84±0.12.

Conclusions:

  • A clear relationship exists between BIS and end-tidal desflurane concentrations below 1 MAC.
  • A BIS range of 40-49 reliably indicates approximately 0.5 MAC of desflurane during desflurane-remifentanil anesthesia.
  • These findings are valuable for optimizing anesthetic depth and facilitating fast-track recovery.