The effects of bispectral index monitoring on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery

Paediatr Anaesth. 2015 Sep;25(9):950-5. doi: 10.1111/pan.12692. Epub 2015 May 13.

Abstract

Background: General anesthesia is often preferred for dental surgery or rehabilitation in developmentally delayed pediatric patients. Bispectral index monitoring is used to monitor the depth of anesthesia and to ensure early recovery. However, studies on the topic in developmentally delayed pediatric patients are limited.

Aim: To evaluate the effects of Bispectral Index Scale (BIS) on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery.

Methods: Forty children between the ages of 6-16 years were studied in this prospective and randomized study. The children were randomized into two groups. In Group 1 (n = 20), general anesthesia was maintained with 1-2 minimum alveolar concentration (MAC) of sevoflurane in oxygen by standard practice. In Group 2 (n = 20), the depth of anesthesia was monitored by BIS. BIS values were continuously recorded from awake status to tracheal extubation. The duration of the surgical procedure, anesthesia, postanesthesia care unit (PACU) stay was noted. To evaluate recovery profile, time to spontaneous ventilation, extubation, open eyes, and PACU discharge were also noted.

Results: There were significant differences between recovery times and Non-communicating Children's Pain Checklist - Postoperative Version (NCCPC-PV) scores of two groups. Time to spontaneous ventilation [Difference in means (95% CI); 3.17 (1.79-4.54) P < 0.001], extubation [Difference in means (95% CI); 3.13 (1.66-4.60) P < 0.001], open eyes [Difference in means (95% CI); 3.97 (2.34-5.59) P < 0.001], and PACU stay time [Difference in means (95% CI); 23.55 (18.08-29.01) P < 0.001] were significantly shorter in Group 2.

Conclusion: In conclusion, results suggest that routine BIS monitoring may be beneficial due to its favorable effects on the recovery profile in developmentally delayed pediatric patients.

Keywords: bispectral index monitoring; dental surgery; developmentally delayed pediatric patients; hemodynamics; recovery profile.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anesthesia Recovery Period*
  • Anesthesia, General
  • Anesthetics, Inhalation
  • Child
  • Developmental Disabilities / surgery*
  • Electroencephalography*
  • Female
  • Hemodynamics / drug effects*
  • Humans
  • Male
  • Methyl Ethers
  • Monitoring, Intraoperative / methods*
  • Oral Surgical Procedures*
  • Prospective Studies
  • Sevoflurane
  • Time Factors

Substances

  • Anesthetics, Inhalation
  • Methyl Ethers
  • Sevoflurane

Associated data

  • ANZCTR/ACTRN12614000890639