EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

ISSN: Active
eISSN: 3023-6738
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Comparison of recovery and side effects after optimal isoflurane/sevoflurane/desflurane anaesthesia with BIS monitoring in patients undergoing laparoscopic abdominal surgery
Abstract
Aims: Rapid recovery of the patient after the surgery is important for the patient to gain consciousness quickly and full wakefulness is important for both anesthesiologist and for the patient. This becomes more important especially in daily surgeries such as laparoscopic surgery procedures. Rapid recovery of consciousness after extubating, spontaneous respiratory sufficiency, adequacy of protective airway reflexes minimizes respiratory side effects during recovery period. In patients under general anesthesia, EEG activity reverts from low-voltage fast waveform to high-voltage slow waveform. BIS anesthesia, as an EEG variant, is a simple and easy-to-use Monitor that measures the depth of anesthesia. With this monitor, it is easier to measure the depth of anesthesia and evaluate the recovery. In our study, we aimed to evaluate the difference between recovery times and side effect rates after Isoflurane/sevoflurane/Desflurane anesthesia.
Methods: 105 patients in ASA I-II risk group between 18-60 years of age whose elective laparoscopic cholecystectomy was planned in our hospital were included in our research. All patients were induced with 2 µg/kg of fentanyl, 2.5 mg/kg of propofol, 0.6 mg/kg of rocuronium for general anesthesia. After intubation, 0.5-1.5% Isoflurane was given to group I, 1-4% sevoflurane to Group II, and 2-6% Desflurane to Group III patients as inhaler agents.
Results: In patient groups for which demographic data do not have any statistically significant difference, monitoring with BIS reduces the amount of anesthetic used in three groups and prevents intraoperative awareness. When compared between groups Desflurane was the fastest recovered group with fastest rising BIS score due to the low blood/gas partition levels. However, contrary to our expectations, sevoflurane was not very different from Isoflurane. In addition, contrary to expected, the incidence of nausea after extubating was higher in this group. But at the end of the 1st hour, emetic symptoms were significantly higher in the sevoflurane group.
Conclusion: BIS use reduces the amount of inhaler agent use in anesthesia depth measurement. In patients with optimal anesthesia depth, postoperative recovery is fast and side effects such as nausea and vomiting reduce. In our study, we determined that Desflurane, which is an agent with low blood/gas partition coefficient, was the fastest to be recovered compared to other groups.

Keywords : General anesthesia, BIS monitoring, recovery

Download Article


1. Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology. 1997; 86(4):836-847. doi:10.1097/00000542-199704000-00014
2. Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology. 1998;88(3):642-650. doi:10.1097/00000542-199803000-00014
3. Sebel PS, Lang E, Rampil IJ, et al. A multicenter study of bispectral electroencephalogram analysis for monitoring anesthetic effect. Anesth Analg. 1997;84(4):891-899. doi:10.1097/00000539-199704000-00035
4. Miller KA, Harkin CP, Bailey PL. Postoperative tracheal extubation.Anesth Analg. 1995;80(1):149-172. doi:10.1097/00000539-199501000-00025
5. Kearse LA Jr, Manberg P, DeBros F, Chamoun N, Sinai V. Bispectral analysis of the electroencephalogram during induction of anesthesia may predict hemodynamic responses to laryngoscopy and intubation. Electroencephalogr Clin Neurophysiol. 1994;90(3):194-200. doi:10.1016/ 0013-4694(94)90091-4
6. Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia.Anesthesiology. 1997;87(4):842-848. doi:10.1097/00000542-199710000-00018
7. Song D, van Vlymen J, White PF. Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane?Anesth Analg. 1998;87(6):1245-1248. doi:10. 1097/00000539-199812000-00006
8. Sebel PS, Lang E, Rampil IJ, et al. A multicenter study of bispectral electroencephalogram analysis for monitoring anesthetic effect.Anesth Analg. 1997;84(4):891-899. doi:10.1097/00000539-199704000-00035
9. Hug CC Jr. Propofol requirements versus stimulus intensity.Anesthesiology. 1997;87(2):201-202. doi:10.1097/00000542-199708000-00004
10. Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology. 1997; 86(4):836-847. doi:10.1097/00000542-199704000-00014
11. Prys-Roberts C. Anaesthesia: a practical or impractical construct? Br J Anaesth. 1987;59(11):1341-1345. doi:10.1093/bja/59.11.1341
12. Burrow B, McKenzie B, Case C. Do anaesthetized patients recover better after bispectral index monitoring?Anaesth Intensive Care. 2001; 29(3):239-245. doi:10.1177/0310057X0102900303
13. Cooper HS, Epstain RH. Clinical utilitiy of the BIS shortening the interval from and of surgery extubation. Anaesthesiology. 1997;87(3): A437
14. Bannister CF, Brosius KK, Sigl JC, Meyer BJ, Sebel PS. The effect of bispectral index monitoring on anesthetic use and recovery in children anesthetized with sevoflurane in nitrous oxide.Anesth Analg. 2001; 92(4):877-881. doi:10.1097/00000539-200104000-00015
15. Olofsen E, Dahan A. The dynamic relationship between end-tidal sevoflurane and isoflurane concentrations and bispectral index and spectral edge frequency of the electroencephalogram.Anesthesiology. 1999;90(5):1345-1353. doi:10.1097/00000542-199905000-00019
16. Tang J, Chen L, White PF, et al. Recovery profile, costs, and patient satisfaction with propofol and sevoflurane for fast-track office-based anesthesia. Anesthesiology. 1999;91(1):253-261. doi:10.1097/00000542-199907000-00034
17. Pavlin DJ, Hong JY, Freund PR, Koerschgen ME, Bower JO, Bowdle TA. The effect of bispectral index monitoring on end-tidal gas concentration and recovery duration after outpatient anesthesia.Anesth Analg. 2001; 93(3):613-619. doi:10.1097/00000539-200109000-00017
18. Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group.Anesthesiology. 1997; 87(4):808-815. doi:10.1097/00000542-199710000-00014
19. Nelskyla KA, Yli-Hankala AM, Puro PH, Korttila KT. Sevoflurane titration using bispectral index decreases postoperative vomiting in phase II recovery after ambulatory surgery. Anesth Analg. 2001;93(5): 1165-1169. doi:10.1097/00000539-200111000-00021
20. Röpcke H, Rehberg B, Koenen-Bergmann M, Bouillon T, Bruhn J, Hoeft A. Surgical stimulation shifts EEG concentration-response relationship of desflurane.Anesthesiology. 2001;94(3):390-5A. doi:10.1097/ 00000542-200103000-00006
21. Johansen JW, Sebel PS, Sigl JC. Clinical impact of hypnotic-titration guidelines based on EEG bispectral index (BIS) monitoring during routine anesthetic care.J Clin Anesth. 2000;12(6):433-443. doi:10.1016/s0952-8180(00)00187-2
22. O'Connor MF, Daves SM, Tung A, Cook RI, Thisted R, Apfelbaum J. BIS monitoring to prevent awareness during general anesthesia.Anesthesiology. 2001;94(3):520-522. doi:10.1097/00000542-200103000-00025
23. Mychaskiw G 2nd, Horowitz M, Sachdev V, Heath BJ. Explicit intraoperative recall at a bispectral index of 47.Anesth Analg. 2001; 92(4):808-809. doi:10.1097/00000539-200104000-00003
Article available in :
Volume 2, Issue 3, 2025
Page : 77-82
https://doi.org/10.51271/EAJAIC-0034
Article Information
Received : 11 Mar 2025
Accepted : 13 May 2025
Published : 06 Ağu 2025
Corresponding Author :

Nilgün Şahin: Division of Anesthesiology and Reanimation, Department of Obstetrics and Gynaecology, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkiye

[email protected]
Citation : Şahin N. Comparison of recovery and side effects after optimal isoflurane/sevoflurane/desflurane anaesthesia with BIS monitoring in patients undergoing laparoscopic abdominal surgery. Eur J Anesthesiol Intens Care. 2025;2(3):77-82.

Read: 777
Download : 999
Cited: 0
_Footer