Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Bispectral index-guided propofol sedation during endoscopic ultrasonography

  • Ayana Okamoto (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Ken Kamata (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Takeshi Miyata (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Tomoe Yoshikawa (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Rei Ishikawa (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Tomohiro Yamazaki (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Atsushi Nakai (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Shunsuke Omoto (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Kosuke Minaga (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Kentaro Yamao (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Mamoru Takenaka (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Yasutaka Chiba (Clinical Research Center, Kindai University Hospital) ;
  • Toshiharu Sakurai (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Naoshi Nishida (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine) ;
  • Masayuki Kitano (Second Department of Internal Medicine, Wakayama Medical University School of Medicine) ;
  • Masatoshi Kudo (Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine)
  • Received : 2021.11.19
  • Accepted : 2022.02.21
  • Published : 2022.07.30
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Abstract

Background/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods: This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room. Results: The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.

Keywords

Acknowledgement

This work was supported by a grant-in-aid from the Japan Research Foundation for Clinical Pharmacology.

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