In recent years, the utilization of the Bispectral Index (BIS) for monitoring anesthesia depth has sparked considerable debate within the medical community. A meticulous meta-analysis and systematic review have been conducted to provide clarity on the efficacy of BIS monitoring compared to conventional methods. This analysis, encompassing data up to April 2023 from extensive databases such as Ovid-MEDLINE, Cochrane, and PubMed, offers critical insights for healthcare professionals.
Study Methodology and Inclusion Criteria
The study meticulously filtered through numerous randomized controlled trials without demographic restrictions, comparing BIS monitoring with traditional anesthesia depth methods. Exclusion criteria ensured the exclusion of duplicates, reviews, animal studies, and incomplete data. Two independent reviewers were tasked with screening the literature, extracting pertinent data, and evaluating the methodological quality of selected studies.
Key Findings and Impact on Anesthesia Practices
The review incorporated forty studies, revealing significant advantages of BIS monitoring over conventional techniques. Notably, BIS monitoring was associated with a reduction in postoperative cognitive dysfunction (RR = 0.85, 95% CI: 0.73∼0.99, P = 0.04). Additionally, BIS monitoring reduced eye-opening time (MD = -1.34, 95% CI: -2.06∼-0.61, P < 0.01), orientation recovery time (MD = -1.99, 95% CI: -3.62∼-0.36, P = 0.02), extubation time (MD = -2.54, 95% CI: -3.50∼-1.58, P < 0.01), and postanesthesia care unit stay time (MD = -7.11, 95% CI: -12.67∼-1.55, P = 0.01). Furthermore, the BIS method was effective in lowering the dosage of anesthesia drugs (SMD = -0.39, 95% CI: -0.63∼-0.15, P < 0.01).
From a market access perspective, the adoption of BIS monitoring could revolutionize anesthesia practices by enhancing patient outcomes and optimizing resource utilization. This could potentially lead to a higher demand for BIS-compatible devices and training for anesthesiologists, thereby influencing market dynamics in the medical technology sector.
Concrete Inferences on BIS Monitoring
- BIS monitoring significantly reduces the risk of postoperative cognitive dysfunction, enhancing patient safety.
- Shorter recovery times associated with BIS monitoring can lead to improved operating room efficiency and reduced healthcare costs.
- Lower anesthesia drug usage with BIS could result in fewer side effects and better patient experiences.
- The broader adoption of BIS technology can drive innovation and competition in the medical device market.
Overall, the findings underscore the effectiveness of BIS monitoring in enhancing the quality of anesthesia care. By reducing recovery times and lowering drug dosages, BIS could play a pivotal role in advancing surgical procedures and patient outcomes.
Original Article:
Anesthesiol Res Pract. 2024 Aug 7;2024:5555481. doi: 10.1155/2024/5555481. eCollection 2024.
ABSTRACT
Background and Objective. The Bispectral Index (BIS) is utilized to guide the depth of anesthesia monitoring during surgical procedures. However, conflicting results regarding the benefits of BIS for depth of anesthesia monitoring have been reported in numerous studies. The purpose of this meta-analysis and systematic review was to assess the effectiveness of BIS for depth of anesthesia monitoring. Search Methods. A systematic search of Ovid-MEDLINE, Cochrane, and PubMed was conducted from inception to April 20, 2023. Clinical trial registers and grey literature were also searched, and reference lists of included studies, as well as related review articles, were manually reviewed. Selection Criteria. The inclusion criteria were randomized controlled trials without gender or age restrictions. The control groups used conventional monitoring, while the intervention groups utilized BIS monitoring. The exclusion criteria included duplicates, reviews, animal studies, unclear outcomes, and incomplete data. Data Collection and Analysis. Two independent reviewers screened the literature, extracted data, and assessed methodological quality, with analyses conducted using R 4.0 software. Main Results. Forty studies were included. In comparison to the conventional depth of anesthesia monitoring, BIS monitoring reduced the postoperative cognitive dysfunction risk (RR = 0.85, 95% CI: 0.73∼0.99, P = 0.04), shortened the eye-opening time (MD = -1.34, 95% CI: -2.06∼-0.61, P < 0.01), orientation recovery time (MD = -1.99, 95% CI: -3.62∼-0.36, P = 0.02), extubation time (MD = -2.54, 95% CI: -3.50∼-1.58, P < 0.01), and postanesthesia care unit stay time (MD = -7.11, 95% CI: -12.67∼-1.55, P = 0.01) and lowered the anesthesia drug dosage (SMD = -0.39, 95% CI: -0.63∼-0.15, P < 0.01). Conclusion. BIS can be used to effectively monitor the depth of anesthesia. Its use in general anesthesia enhances the effectiveness of both patient care and surgical procedures.
PMID:39149130 | PMC:PMC11325011 | DOI:10.1155/2024/5555481
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