The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study
Abstract Background The desired depth of sedation during flexible bronchoscopy is one in which verbal contact is possible whenever necessary. Although it is common that the depth of sedation is assessed by validated instruments such as the modified observer's assessment of alertness and sedatio...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-11-01
|
| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.14658 |
| _version_ | 1811333218808365056 |
|---|---|
| author | Jun Yamada Daisuke Hazama Motoko Tachihara Yuki Kawanami Aki Kawaguchi Atsuhiko Yatani Hiroki Sato Chihiro Mimura Naoko Katsurada Masatsugu Yamamoto Yoshihiro Nishimura Kazuyuki Kobayashi |
| author_facet | Jun Yamada Daisuke Hazama Motoko Tachihara Yuki Kawanami Aki Kawaguchi Atsuhiko Yatani Hiroki Sato Chihiro Mimura Naoko Katsurada Masatsugu Yamamoto Yoshihiro Nishimura Kazuyuki Kobayashi |
| author_sort | Jun Yamada |
| collection | DOAJ |
| description | Abstract Background The desired depth of sedation during flexible bronchoscopy is one in which verbal contact is possible whenever necessary. Although it is common that the depth of sedation is assessed by validated instruments such as the modified observer's assessment of alertness and sedation (MOAA/S) score, the repeated stimulation associated with the assessment can affect the sedation. The bispectral index (BIS) has been widely used for general anesthesia due to its objective and noninvasive nature. However, the utility of BIS monitoring and a target BIS value for use during bronchoscopy have not been fully elucidated. Methods We performed a retrospective observational study to assess the utility of the BIS value for monitoring conscious sedation during bronchoscopy at Kobe University Hospital from August 2020 to April 2021. Results Eighteen patients underwent bronchoscopy with BIS monitoring. The BIS value significantly correlated with the MOAA/S score (r = 0.2, p < 0.01), and the correlation was stronger in sufficiently sedated patients (r = 0.486, p < 0.01). The lowest MOAA/S score during the procedure was highly correlated with the BIS value (r = 0.625, p < 0.01). The BIS monitoring seemed to be more sensitive to changes in the sedation level than the MOAA/S score, heart rate and mean arterial pressure. The median BIS value at an MOAA/S score of 3–4, the desired depth of sedation, was 82.0. Conclusions BIS value is useful for monitoring sedation during bronchoscopy. This study suggests that a BIS value of 82 reflects an adequate level of sedation. |
| first_indexed | 2024-04-13T16:49:42Z |
| format | Article |
| id | doaj.art-d90ea08029b447ada6e7d44ede612935 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-13T16:49:42Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-d90ea08029b447ada6e7d44ede6129352022-12-22T02:38:59ZengWileyThoracic Cancer1759-77061759-77142022-11-0113213052305710.1111/1759-7714.14658The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational studyJun Yamada0Daisuke Hazama1Motoko Tachihara2Yuki Kawanami3Aki Kawaguchi4Atsuhiko Yatani5Hiroki Sato6Chihiro Mimura7Naoko Katsurada8Masatsugu Yamamoto9Yoshihiro Nishimura10Kazuyuki Kobayashi11Division of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDepartment of Clinical Engineering Kobe University Hospital Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanDivision of Respiratory Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe JapanAbstract Background The desired depth of sedation during flexible bronchoscopy is one in which verbal contact is possible whenever necessary. Although it is common that the depth of sedation is assessed by validated instruments such as the modified observer's assessment of alertness and sedation (MOAA/S) score, the repeated stimulation associated with the assessment can affect the sedation. The bispectral index (BIS) has been widely used for general anesthesia due to its objective and noninvasive nature. However, the utility of BIS monitoring and a target BIS value for use during bronchoscopy have not been fully elucidated. Methods We performed a retrospective observational study to assess the utility of the BIS value for monitoring conscious sedation during bronchoscopy at Kobe University Hospital from August 2020 to April 2021. Results Eighteen patients underwent bronchoscopy with BIS monitoring. The BIS value significantly correlated with the MOAA/S score (r = 0.2, p < 0.01), and the correlation was stronger in sufficiently sedated patients (r = 0.486, p < 0.01). The lowest MOAA/S score during the procedure was highly correlated with the BIS value (r = 0.625, p < 0.01). The BIS monitoring seemed to be more sensitive to changes in the sedation level than the MOAA/S score, heart rate and mean arterial pressure. The median BIS value at an MOAA/S score of 3–4, the desired depth of sedation, was 82.0. Conclusions BIS value is useful for monitoring sedation during bronchoscopy. This study suggests that a BIS value of 82 reflects an adequate level of sedation.https://doi.org/10.1111/1759-7714.14658BIS valueflexible bronchoscopyMOAA/S scoresedation |
| spellingShingle | Jun Yamada Daisuke Hazama Motoko Tachihara Yuki Kawanami Aki Kawaguchi Atsuhiko Yatani Hiroki Sato Chihiro Mimura Naoko Katsurada Masatsugu Yamamoto Yoshihiro Nishimura Kazuyuki Kobayashi The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study Thoracic Cancer BIS value flexible bronchoscopy MOAA/S score sedation |
| title | The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study |
| title_full | The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study |
| title_fullStr | The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study |
| title_full_unstemmed | The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study |
| title_short | The utility of bispectral index monitoring in flexible bronchoscopy: A single‐center, retrospective observational study |
| title_sort | utility of bispectral index monitoring in flexible bronchoscopy a single center retrospective observational study |
| topic | BIS value flexible bronchoscopy MOAA/S score sedation |
| url | https://doi.org/10.1111/1759-7714.14658 |
| work_keys_str_mv | AT junyamada theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT daisukehazama theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT motokotachihara theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT yukikawanami theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT akikawaguchi theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT atsuhikoyatani theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT hirokisato theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT chihiromimura theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT naokokatsurada theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT masatsuguyamamoto theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT yoshihironishimura theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT kazuyukikobayashi theutilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT junyamada utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT daisukehazama utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT motokotachihara utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT yukikawanami utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT akikawaguchi utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT atsuhikoyatani utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT hirokisato utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT chihiromimura utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT naokokatsurada utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT masatsuguyamamoto utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT yoshihironishimura utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy AT kazuyukikobayashi utilityofbispectralindexmonitoringinflexiblebronchoscopyasinglecenterretrospectiveobservationalstudy |