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Prospective randomized trial of bispectral index monitoring of sedation depth during flexible bronchoscopy . BACKGROUND The clinical benefits associated with the use of the bispectral index ( BIS ) to monitor the depth of sedation during flexible fiberoptic bronchoscopy ( FFB ) are questionable . OBJECTIVES To evaluate the added value in terms of procedural safety and patients ' awareness of monitoring sedation depth using the BIS compared to conventional clinical judgment alone in patients undergoing FFB under propofol sedation . METHODS The cohort included 81 patients undergoing diagnostic or therapeutic bronchoscopy under propofol sedation that were prospectively randomized to guide the depth of sedation by BIS monitoring ( BIS group ; n = 40 ) or conventional monitoring ( control group ; n = 41 ) . RESULTS The mean durations of the procedure were 18 and 19 min in the BIS and control groups , respectively . No significant difference was noted in the dosage of propofol used between the BIS and control groups ( 168.7 vs. 167.3 mg , respectively ) . Average sedation-related oxygen saturation drop and transcutaneous CO2 rise were not significantly different between groups . There was also no significant difference in the percentage of patients that required either hemodynamic support ( 5 vs. 7.5 % , respectively ) , oxygen supplementation by 100 % O2 mask ( 67.5 vs. 82.5 % , respectively ) or Ambu face mask manual ventilation ( 2.5 vs. 5 % , respectively ) between the groups . No significant difference was noted in terms of patients ' awareness during the procedure , which was assessed following recovery by a structured Brice interview . CONCLUSION Using BIS to guide the depth of sedation during propofol sedation in patients undergoing FFB of relatively short duration offers no clinically significant advantages over conventional monitoring .
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Intervention_Physical
monitoring
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Intervention_Physical
bispectral index ( BIS
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Intervention_Pharmacological
propofol sedation
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Intervention_Physical
BIS monitoring
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Intervention_Control
conventional monitoring
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Outcome_Physical
depth of sedation
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Outcome_Physical
depth of sedation
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Outcome_Other
dosage of propofol
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Outcome_Physical
Average sedation-related oxygen saturation
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Outcome_Physical
transcutaneous CO2
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Outcome_Mental
patients ' awareness
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Participant_Sample-size
81
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Participant_Condition
diagnostic or therapeutic bronchoscopy under propofol sedation
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Participant_Condition
patients undergoing FFB of relatively short duration