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

Guoliang Liu1, Jianmin Zhang1, Fang Wang1

  • 1Department of Anesthesiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.

Frontiers in Neurology
|November 28, 2022
PubMed

Insights

Bispectral index (BIS) guided total intravenous anesthesia (TIVA) in younger children did not reduce extubation time or PACU stay. This study evaluated BIS-guided TIVA effects in pediatric patients aged 1-3 years.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Intensive Care Medicine

Background:

  • Total intravenous anesthesia (TIVA) using bispectral index (BIS) guidance is common in pediatric patients.
  • Limited research exists on the efficacy of BIS-guided TIVA in very young children (1-3 years old).

Purpose of the Study:

  • To evaluate the impact of bispectral index (BIS) monitoring on total intravenous anesthesia (TIVA) in pediatric patients aged 1-3 years.
  • To compare outcomes between BIS-guided TIVA and standard clinical practice in this age group.

Main Methods:

  • A prospective, randomized, single-blind, controlled trial involving pediatric patients (1-3 years) undergoing TIVA with propofol and remifentanil.
  • Patients were randomized into a BIS-guided group (maintained at 45-60) or a standard care group.
  • Key outcomes included extubation time, PACU stay duration, BIS values, hemodynamic parameters, and adverse events.

Main Results:

  • No significant differences were observed in extubation time or PACU stay duration between the BIS-guided and standard care groups.
  • BIS values were significantly lower in the BIS-guided group compared to the standard group at specific intraoperative time points (30 min, 60 min, and immediately after drug withdrawal).

Conclusions:

  • Bispectral index (BIS) guided total intravenous anesthesia (TIVA) does not appear to shorten extubation time or reduce the duration of post-anesthesia care unit (PACU) stay in younger children (1-3 years).
  • Further research may be needed to explore potential benefits or alternative applications of BIS monitoring in pediatric anesthesia.
Abstract

Keywords:
bispectral indexpropfolrecoverytotal intravenous anesthesiayounger children

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