Sk Amithkumar, Kadlimatti Deepak V, Kumar Santosh, Divya Palla Sree, Ajith Mithra
Department of Anaesthesiology, Dr. B.R. Ambedkar Medical College & Hospital, Bengaluru, IND.
Cureus. 2025 Jun 25;17(6):e86742. doi: 10.7759/cureus.86742. eCollection 2025 Jun.
The objective of this study was to compare extubation timings between patients monitored with the bispectral index (BIS) and those monitored using end-tidal anesthetic gas (ETAG) to determine which method provides a more efficient recovery profile.
A prospective observational study was conducted on 50 patients aged 18 to 60 years, classified as American Society of Anesthesiologists (ASA) physical status I-II, undergoing elective surgeries under general anesthesia (GA). Patients were randomized into BIS and non-BIS (ETAG) groups to assess anesthetic consumption and recovery characteristics. Standard anesthetic protocols were followed. In the BIS group, BIS values were maintained between 40 and 60, while in the ETAG group, end-tidal isoflurane concentrations were kept between 0.7 and 1.3 minimum alveolar concentration (MAC). Intraoperative parameters and extubation times were recorded. Isoflurane administration was discontinued at the time of skin closure, and neuromuscular blockade was reversed once a train-of-four (TOF) ratio greater than 0.9 was confirmed. Data were analyzed using SPSS version 26.0 (IBM Corp., Armonk, NY), with a p-value less than 0.05 considered statistically significant.
There was no statistically significant difference in the overall duration of anesthesia between the two groups (p > 0.05). However, the BIS group had a significantly shorter extubation time, averaging 148.4 ± 30.5 seconds, compared to 201.2 ± 43.6 seconds in the ETAG group. The mean difference was 52.8 ± 13.1 seconds (p = 0.001). Additionally, the average hourly isoflurane consumption was significantly lower in the BIS group (5.9 ± 0.77 mL) compared to the ETAG group (6.56 ± 1.12 mL), with a mean difference of 0.66 ± 1.04 mL (p = 0.01).
Extubation occurred significantly earlier in patients monitored with BIS than in those observed with ETAG. Furthermore, BIS-guided anesthesia was associated with reduced isoflurane consumption compared to ETAG-guided monitoring.
本研究的目的是比较使用脑电双频指数（BIS）监测的患者与使用呼气末麻醉气体（ETAG）监测的患者的拔管时机，以确定哪种方法能提供更有效的恢复情况。
对50例年龄在18至60岁之间、美国麻醉医师协会（ASA）身体状况为I-II级、接受全身麻醉（GA）下择期手术的患者进行了一项前瞻性观察研究。将患者随机分为BIS组和非BIS组（ETAG组），以评估麻醉药物消耗和恢复特征。遵循标准麻醉方案。在BIS组中，BIS值维持在40至60之间，而在ETAG组中，呼气末异氟烷浓度保持在0.7至1.3最低肺泡浓度（MAC）之间。记录术中参数和拔管时间。皮肤缝合时停止给予异氟烷，一旦四个成串刺激（TOF）比值大于0.9得到确认，就逆转神经肌肉阻滞。使用SPSS 26.0版（IBM公司，纽约州阿蒙克）对数据进行分析，p值小于0.05被认为具有统计学意义。
两组之间的总体麻醉持续时间没有统计学显著差异（p>0.05）。然而，BIS组的拔管时间明显更短，平均为148.4±30.5秒，而ETAG组为201.2±43.6秒。平均差异为52.8±13.1秒（p = 0.001）。此外，BIS组的平均每小时异氟烷消耗量（5.9±0.77 mL）明显低于ETAG组（6.56±1.12 mL），平均差异为0.66±1.04 mL（p = 0.01）。
使用BIS监测的患者比使用ETAG监测的患者拔管明显更早。此外，与ETAG引导监测相比，BIS引导麻醉与异氟烷消耗量减少有关。
