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Postoperative Recovery with Bispectral Index versus Anesthetic Concentration-Guided Protocols.
MedLine Citation:
PMID:  23353791     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Use of the bispectral index (BIS) monitor has been suggested to decrease excessive anesthetic drug administration, leading to improved recovery from general anesthesia. The purpose of this substudy of the B-Unaware and BAG-RECALL trials was to assess whether a BIS-based anesthetic protocol was superior to an end-tidal anesthetic concentration-based protocol in decreasing recovery time and postoperative complications. METHODS:: Patients at high risk for awareness were randomized to either BIS-guided or end-tidal anesthetic concentration-guided general anesthesia in the original trials. Outcomes included time to postanesthesia care unit discharge readiness, time to achieve a postoperative Aldrete score of 9-10, intensive care unit length of stay, postoperative nausea and vomiting, and severe postoperative pain. Univariate Cox regression and chi-square tests were used for statistical analyses. RESULTS:: The BIS cohort was not superior in time to postanesthesia care unit discharge readiness (hazard ratio, 1.0; 95% CI, 1.0-1.1; n = 2,949), time to achieve an Aldrete score of 9-10 (hazard ratio, 1.2; 95% CI, 1.0-1.4; n = 706), intensive care unit length of stay (hazard ratio, 1.0; 95% CI, 0.9-1.1; n = 2,074), incidence of postoperative nausea and vomiting (absolute risk reduction, -0.5%; 95% CI, -5.8 to 4.8%; n = 789), or incidence of severe postoperative pain (absolute risk reduction, 4.4%; 95% CI, -2.3 to 11.1%; n = 759). CONCLUSIONS:: In patients at high risk for awareness, the BIS-guided protocol is not superior to an anesthetic concentration-guided protocol in time needed for postoperative recovery or in the incidences of common postoperative complications.
Bradley A Fritz; Preetika Rao; George A Mashour; Arbi Ben Abdallah; Beth A Burnside; Eric Jacobsohn; Lini Zhang; Michael S Avidan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-24
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
* Medical Student, ‡ Research Assistant Professor, § Project Manager, # Research Assistant, ** Professor, Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri. † Assistant Professor, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan. ‖ Professor, Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
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