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Anesthesia: Essays and Researches

Original Article

Effect of bispectral index monitoring on desflurane consumption and recovery time in morbidly obese patients undergoing laparoscopic sleeve gastrectomy Tamer H. Ibrahim, Gamal T. Yousef, Ali M. Ali Hasan, Hossam I. Eldesuky Department of Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt Corresponding author: Prof. Gamal T. Yousef, Department of Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E‑mail: [email protected]

Abstract Background: Morbid obesity magnifies the importance of the fat–blood solubility coefficient of the anesthetic in its relation to emergence and recovery. Using bispectral index (BIS) monitoring for the titration of the administration of inhaled anesthetics such as desflurane may permit a less consumption and more rapid recovery from desflurane anesthesia in morbidly obese patients, which enables earlier maintenance of a patent airway, better protection against aspiration, and better oxygenation. Objective: The aim of this study was to investigate the effect of BIS monitoring on postoperative extubation and recovery times, and intraoperative desflurane consumption in morbidly obese patients undergoing laparoscopic sleeve gastrectomy under general anesthesia using desflurane for maintenance. Patients and Methods: Forty morbidly obese patients were randomly enrolled in this study and divided into two groups of 20  patients each: Non‑BIS group and BIS group. End‑tidal desflurane concentration, mean blood pressure, and heart rate were regularly recorded. Recovery times (eye opening to verbal commands, time to extubation, and orientation to time, place, and person) and the time to achieve a modified Aldrete score of ≥ 9 were recorded by blinded study anesthesia nurse. Desflurane consumption was calculated in milliliters through gas usage option of Datex‑Ohmeda S/5 anesthesia machine. Results: The mean end‑tidal concentrations of desflurane were significantly decreased in the BIS group compared to the non‑BIS group  (P  0.05 (NS)

Duration of surgery (min)

185±15

190±13

>0.05 (NS)

Duration of anesthesia (min)

220±10

212±12.7

>0.05 (NS)

P>0.05, NS = non significant

Table 2: Desflurane consumption and recovery times (min), mean±SD P value

Non‑BIS group (n=20)

BIS group (n=20)

150.6±6.5

124.8±5.1*

P

Effect of bispectral index monitoring on desflurane consumption and recovery time in morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

Morbid obesity magnifies the importance of the fat-blood solubility coefficient of the anesthetic in its relation to emergence and recovery. Using bis...
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