Assessment of Bispectral Index Monitor During Flexible Bronchoscopy Performed Under Conscious Sedation

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Objective. For safe flexible bronchoscopy, it is essential that the sedation level be evaluated accurately. A prospective study was undertaken to determine usefulness of the bispectral index (BIS) monitor system during flexible bronchoscopy and evaluate how much amnesia patients experienced. Methods. We performed flexible bronchoscopy in 42 patients. Injections of midazolam (2.5 mg) were administered until amnesia was achieved. BIS values were recorded continuously. Injection of midazolam (2.5 mg) was administered when BIS value remained over 85 for 30 seconds, but not for coughs or body movement when BIS value stayed below 80. Results. There were 31 patients (74%) who remembered nothing at all, 11 (26%) who remembered no details, and none (0%) who remembered some details, many details, or every detail. Regarding patient satisfaction, 25 patients (60%) felt "excellent" or "good" during premedication, 33 (79%) during the bronchoscopic procedure, 28 (67%) during the post-bronchoscopic procedure, and 34 (81%) during the total procedure. The mean BIS value of patients was 76.4±5.2 during the bronchoscopic procedure; the minimum mean BIS value was 65, and the maximum mean BIS value was 85. BIS values rose 7 to 40 (17.9±7.6) with coughs or body movement. BIS value (76.4±4.9) of patients who remembered nothing at all was similar to that (74.3±4.8) of patients who remembered no details. BIS values did not suggest the degree of patient memory or satisfaction. Conclusions. BIS value is useful in the administration of midazolam and keeps patients at an appropriate level of sedation. The BIS value taken during flexible bronchoscopy is not an indicator of patient memory or satisfaction.
日本呼吸器内視鏡学会の論文
2014-01-25

Assessment of Bispectral Index Monitor During Flexible Bronchoscopy Performed Under Conscious Sedation

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