Home E-Weekly October 10, 2017

Deeper Anesthesia Reduces Post-Op Pain, PONV

Published: October 9, 2017

DEEP THOUGHTS Researchers used the bispectral index to gauge depth of anesthesia with lap chole patients.

Patients who are deeply anesthetized during surgery wake up in less pain, are less likely to experience PONV and are generally more satisfied with their care, suggests a recent study.

Researchers based their findings on use of the bispectral index (BIS), which is based on several EEG subparameters and is designed to indicate depth of anesthesia on a scale between 0 and 100. The lower the number, the deeper the hypnotic state. (Theoretically, a fully awake state would produce a measurement of 100.)

Sixty patients who were scheduled to undergo lap choles were randomly divided into 2 groups. One group was maintained within the low bispectral index (L-BIS, 35-44), the other within the high bispectral index (H-BIS, 45-55). Otherwise, the anesthesia protocol was the same for both groups (propofol and remifentanil).

The L-BIS group had significantly lower pain scores at 8, 16 and 24 hours after surgery, and fewer L-BIS patients needed additional sedatives during recovery (18 L-BIS vs. 27 H-BIS). The L-BIS group also had less nausea 8 hours after surgery (no nausea occurred in either group at the 16- and 24-hour marks).

Jim Burger

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