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The effect of BIS usage on anaesthetic agent consumption in high-risk patients for coronary artery bypass grafting off-pump surgery
Sanjeev Singh1, Pavagada Shaifulla2, Arti Singh3, Isaac Okyere4
1 Department of Anaesthesiology and Intensive Care, SMD, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Anaesthesiology and Intensive Care, SAMSRI, Lucknow, Uttar Pradesh, India
2 Department of Medicine, Viswabhatathi Medical College, Kurnool, Andhra Pradesh, India
3 Department of Public Health, SMD, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
4 Department of Surgery, SMD, CHS, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Correspondence Address:
Sanjeev Singh,
Department of Anaesthesiology and Intensive Care, Kwame Nkrumah University of Science and Technology, Kumasi
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/hmj.hmj_37_22
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Introduction: In this study, we aimed to compare whether the use of the Bispectral Index (BIS) reduces the consumption of the anaesthetic drug and improves recovery time in coronary artery bypass grafting off-pump (CABG-OP) surgery without awareness during surgery (ADS). Materials and Methods: This was a prospective, single-centre, randomised and double-blind comparative research performed on the American Society of Anaesthesiologists (PS) III patients booked for elective CABG-OP surgery under general anaesthesia. Patients received either propofol or isoflurane anaesthesia, and their consumption was calculated and compared. The conventional groups conventional propofol infusion group (CPG)-1 and conventional isoflurane group (CIG-3) received propofol and isoflurane, and haemodynamic parameters (±20% of initial values) were used to check the depth of anaesthesia. The groups BIS-guided propofol infusion group (BPG-2) and BIS-guided isoflurane group (BIG-4) received propofol and isoflurane, and BIS (value 50 ± 5) were used to check the depth of anaesthesia. In addition, haemodynamic parameters, awakening conditions, length of intubation, hospital stay and drug utilisation were recorded. To explicit ADS, patients were interviewed 24 h after extubation. Results: The quantity of propofol used was 178 ± 11 ml in CPG-1 and 117 ± 6 ml in BPG-2, with a 34.26% reduction with BIS. The isoflurane used was 39 ± 8 ml in CIG-3 and 25 ± 6 ml in BIG-4, with a 35.89% reduction in isoflurane requirement. This difference was statistically significantly low with BIS monitored anaesthesia compared to conventional anaesthesia. The length of intubation was 2.2 ± 1.27 and 2.3 ± 1.49 h in groups BPG-2 and BIG-4, respectively (P < 0.05). Conclusion: BIS monitoring aids CABG-OP surgeries by monitoring the depth of anaesthesia (BIS value 50 ± 5), preventing ADS (0%), reducing the anaesthetic agent requirement (propofol 34.26% and isoflurane 35.89%), reducing myocardial depression (mean arterial pressure maintained >74 mmHg) and aiding ultra-fast-track extubation (37% and 50% reduction in the duration of intubation in propofol and isoflurane with BIS).
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