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Efficacy of Bispectral Index Monitoring During Balanced Propofol Sedation for Colonoscopy: A Prospective, Randomized Controlled Trial

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Abstract

Background and Aims

Appropriate use of propofol is necessary, and objective monitoring of sedation with propofol may be helpful. Studies on the efficacy of bispectral index (BIS) monitoring in deep sedation have been conducted, but its efficacy in colonoscopy with moderate sedation is unknown. In this study, the efficacy of BIS monitoring during colonoscopy with moderate level sedation via balanced propofol sedation was investigated.

Methods

To determine the cut-off value of BIS before the test, an optimal BIS value was determined. Patients who were scheduled to undergo outpatient colonoscopy were prospectively randomized to either a BIS or control group. Finally, a total of 115 patients were selected for this study. The satisfaction level, the complication, and the dosage of the administered propofol were compared.

Results

The BIS values and the modified observer’s assessment of alertness/sedation scores (MOAA/S) were positively correlated (r = 0.66 and p < 0.001). The optimal cut-off value of BIS for maintaining moderate sedation was 81, and the area under the ROC curve was 0.88 (95 % CI 0.82–0.93), indicating high prediction accuracy. However, there was no difference between the BIS group and the control group in levels of satisfaction of either patients or endoscopists. In addition, there was no difference in the complication and the required dose of propofol between both groups.

Conclusions

BIS and clinical sedation scores, MOAA/S scores, showed a high level of correlation. However, no significant efficacy was observed in the BIS group who underwent outpatient colonoscopy.

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Acknowledgment

This work was supported by the research fund of the Hanyang University Institute of Aging, Society in 2011.

Conflict of interest

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul Metropolitan Dongbu Hospital, Seoul, Korea

    Yeon Hwa Yu

  2. Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea

    Dong Soo Han, Hyun Soo Kim, Eun Kyung Kim, Chang Soo Eun & Kyo-Sang Yoo

  3. Department of Anesthesia and Pain Medicine, Hanyang University College of Medicine, Guri, Korea

    Woo Jong Shin

  4. Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seungho Ryu

  5. Division of Gastroenterology, Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomun-dong, Guri-si, Gyunggi-do, 471-701, Korea

    Dong Soo Han

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  1. Yeon Hwa Yu
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Correspondence to Dong Soo Han.

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Yu, Y.H., Han, D.S., Kim, H.S. et al. Efficacy of Bispectral Index Monitoring During Balanced Propofol Sedation for Colonoscopy: A Prospective, Randomized Controlled Trial. Dig Dis Sci 58, 3576–3583 (2013). https://doi.org/10.1007/s10620-013-2833-4

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  • DOI: https://doi.org/10.1007/s10620-013-2833-4

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