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.