Document Type : Regular Article
Authors
1 Department of Anaesthesiology and Intensive Care, CHS, Kwame Nkrumah University of Science and Technology – Ghana Department of Anaesthesiology and Intensive Care, SAMSRI – India
2 School of Public Health, CHS, Kwame Nkrumah University of Science and Technology – Ghana
3 Department of Medicine, Viswabhatathi Medical College – India
Abstract
The aim of this study was to compare whether the Bispectral Index (BIS) reduces anaesthesia consumption and improves recovery time in coronary artery bypass grafting-off-pump (CABG) surgery without awareness during surgery (ADS). The study was a prospective, randomised and double-blind comparative study of ASA3 patients enrolled for elective CABG surgery under general anaesthesia (GA). Patients received either propofol or isoflurane anaesthesia and their consumption was calculated and compared. Conventional groups CPG-1 and CIG-3 received propofol and isoflurane, and haemodynamic parameters (± 20% of baseline values) were considered for anaesthesia. Groups BPG-2 and BIG-4 received propofol and isoflurane, and the BIS (value 50±5) was used for maintenance of anaesthesia. Haemodynamic parameters, wake-up conditions, duration of intubation, hospital stay and drug consumption were also recorded. For explicit ADS, patients were interviewed 24 hours after extubation. The amount of propofol used was 178 ± 11 ml in CPG-1 and 117 ± 6 ml in BPG-2, with a 34.26% reduction in BIS. The amount of isoflurane used was 39 ± 8 ml in CIG-3 and 25 ± 6 ml in BIG-4, corresponding to a 35.89% reduction in isoflurane requirements. This difference was statistically significant in BIS monitored anaesthesia compared to conventional anaesthesia. The duration of intubation was 2.2 ±1.27 and 2.3 ±1.49 hours in the BPG-2 and BIG-4 groups, respectively (p<0.05). BIS-assisted CABG surgery with adequate depth of anaesthesia (BIS 50 ± 5) prevents ADS, reduces anaesthetic need for anaesthetics and facilitates ultrafast (UFT) extubation.
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