Evidence map›Paper›PMID 17943802›Full record

SynthesisThe Cochrane database of systematic reviews2007

Bispectral index for improving anaesthetic delivery and postoperative recovery.

Y Punjasawadwong, N Boonjeungmonkol, A Phongchiewboon

3 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 60 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02576015 naunknown statusnot on this mapstarted 2016, after this paper: background citation

The Effect of Continuous Femoral Nerve Block With Modulation of Depth of Anesthesia on Prognosis of Patients Receiving Total Knee Arthroplasty

TypeinterventionalSponsorMin SuRan2016Enrolled380ConditionsPain Management, Sedation, Peripheral Nerve Block, Total Knee ArthroplastyArmsperi-operative continuous femoral nerve block with light sedation, post-operative continuous femoral nerve block, lidocaine, ultrasound, insulated needle (Contiplex B Braun, Melsungen, Germany)
NCT03353311 completednot on this mapstarted 2014, after this paper: background citation

ERAS Lazio Network Clinical Registry

Typeobservational_patient_registrySponsorPERSIANI ROBERTORan2014 to 2017Enrolled1,000ConditionsColon Cancer, Diverticulum, Colon
NCT04331756 nacompletednot on this mapstarted 2017, after this paper: background citation

Use of Tragus Pressure in Guiding Emergence From Anaesthesia- a Randomised Controlled Trial

TypeinterventionalSponsorNational University Hospital, SingaporeRan2017 to 2021Enrolled405ConditionsAnesthesiaArmsGuiding Emergence From Anaesthesia With Tragus Pressure, Guiding Emergence From Anaesthesia Without Tragus Pressure
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 8 syntheses or guidelines pooled it, 181 citations in OpenAlex.

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  16. Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques--a randomized controlled study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2011
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Y PunjasawadwongChiang Mai University, Department of Anesthesiology, Faculty of Medicine, Chiang Mai, Thailand, 50200. ypunjasa@mail.med.cmu.ac.th
N Boonjeungmonkol
A Phongchiewboon
Chiang Mai University · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. The use of bispectral index to guide the dose of anaesthetics may have certain advantages over clinical signs.

objectivesThe objective of this review was to assess whether bispectral index (BIS) reduced anaesthetic use, recovery times, recall awareness and cost. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 2), MEDLINE (1990 to May 2007), EMBASE (1990 to May 2007) and reference lists of articles. SELECTION CRITERIA: We included randomized controlled trials comparing BIS with clinical signs (CS) in titrating anaesthetic agents. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality, extracted data and analysed the data. We contacted study authors for further details. MAIN

resultsWe included 20 studies with 4056 participants. Seven recent trials are still awaiting assessment. BIS-guided anaesthesia reduced the requirement for propofol by 1.30 mg/kg/hr (578 participants; 95% confidence interval (CI) -1.97 to -0.62) and for volatile anaesthetics (desflurane, sevoflurane, isoflurane) by 0.17 minimal alveolar concentration equivalents (MAC) (689 participants; 95% CI -0.27 to -0.07). Irrespective of the anaesthetic, BIS reduced the recovery times: time for eye opening by 2.43 min (996 participants; 95% CI -3.60 to -1.27), response to verbal command by 2.28 min (717 participants; 95% CI -3.47 to -1.09), time to extubation by 3.05 min (1057 participants; 95% CI -3.98 to -2.11) and orientation by 2.46 min (316 participants; 95% CI -3.21 to -1.71). BIS shortened the duration of postanaesthesia care unit stay by 6.83 min (584 participants; 95% CI -12.08 to -1.58) but did not reduce time to home readiness (329 participants; 95% CI -30.11 to 16.09). The BIS-guided anaesthesia significantly reduced the incidence of intraoperative recall awareness in surgical patients with high risk of awareness (OR 0.20, 95% CI 0.05 to 0.79). AUTHORS'

conclusionsAnaesthesia guided by BIS within the recommended range (40 to 60) could improve anaesthetic delivery and postoperative recovery from relatively deep anaesthesia. In addition, BIS-guided anaesthesia has a significant impact on reduction of the incidence of intraoperative recall in surgical patients with high risk of awareness.

Indexed as

Anesthesia Recovery PeriodElectroencephalographyAnesthesiologyAnestheticsHumansMonitoring, IntraoperativeAnesthetics

Identifiers

PMID17943802
OpenAlexW4247583872

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.