Introduction. An objective anesthetic depth control is important for the safe and clinically effective reduction of the ventilator support duration time. The aim of the study is to evaluate the effectiveness and feasibility of the anesthetic depth monitoring using bispectral index (BIS) in patients after open heart surgery.
Materials and methods. A prospective analysis of 176 patients (mean age 59.2±8.7 years) who were divided into initial group (n = 91) with intraoperative anesthetic depth monitoring and control group (n = 85) was performed.
Results. Monitoring the depth of anesthesia is associated with early extubation and shortening of ICU length of stay. The rate of ventilator support duration time less than 6 hours in initial and control groups was of 11 and 2.4%, respectively. The rate of ventilator support duration time less than 24 hours in initial and control groups was 84.6 and 68.3%, respectively. The rate of ICU length of stay less than 24 hours in initial and control groups was of 79.1 and 63.5%, respectively. Monitoring the depth of anesthesia significantly reduces the rates of postoperative vascular insufficiency (13.2 vs. 28.2%), acute reactive psychosis (0 vs. 4.7%) and metabolic disorders (13.2 vs. 25.9%). Moreover, there was a tendecy to significant reduction of excessive bleeding in the initial group (4.4 vs. 11.8%). The comparative analysis on the rates of infectious complications, heart, respiratory and multi-organ failure did not reveal significant differences in two groups.
Conclusion. Anesthetic depth control using BIS index during open heart surgery improves hemodynamic parameters reducing the doses of anesthetics and narcotic analgesic agents. The use of depth of anesthesia monitoring is associated with early extubation, reduced risk of intra- and postoperative complications and shortened time of ICU length of stay.
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