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Korean Journal of Anesthesiology 2003;44(3):370-375.
DOI: https://doi.org/10.4097/kjae.2003.44.3.370   
The Usefulness of the Bispectral Index during Propofol and Fentanyl Anesthesia for Coronary Bypass Surgery under Cardiopulmonary Bypass.
Soo Chang Kim, Chung Su Kim, Hyun Sung Cho, Sang Min Lee
1Department of Anesthesiology and Pain Medicine, Ilsan Grace Hospital, Seoul, Korea.
2Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. marialee@smc.samsung.co.kr
The incidence of intraoperative awareness is known to be high in cardiac surgery using cardiopulmaonary bypass, and there is a tendency to use more anesthetics to maintain anesthesia without recall. We investigated the usefulness of the bispectral index monitor in reducing the amount of anesthetics without intraoperative awareness.
Forty patients scheduled for elective coronary artery bypass graft surgery under cardiopulmonary bypass were randomly allocated into two groups. In the control group, systemic blood pressure was a main indicator to contol the infusion rate of propofol and fentanyl. Infusion rate of propofol and fentanyl were controlled by the bispectral index in the BIS group. A post- anesthetic interview relating to intraoperative awareness was performed on the second postoperative day by a research assistant.
The average flow rate of propofol (control group; 0.137+/-0.012 mg/kg/min, BIS group; 0.110+/-0.003 mg/kg/min, P<0.01) and fentanyl (control group; 6.485+/-0.413mug/kg/h, BIS group; 4.321+/-0.5mug/kg/h, P<0.01) were significantly different between groups. The postoperative extubation time was 6.8+/-1.9 h in the control group and 5.3+/-2.3 h in the BIS group (P<0.05). The average BIS was 43.1+/-5.6. No subjects showed positive results in the intraoperative awareness test.
Intraoperative monitoring of the bispectral index in patients undergoing cardiopulmonary bypass for coronary bypass surgery reduced requirement of anesthetics without intraoperative awareness.
Key Words: Intraoperative awareness; bispectral index; cardiac surgery; cardiopulmonary bypass; propofol; fentanyl


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