A comparative randomized study on effect of bispectral index versus end-tidal anesthetic gas concentration-guided protocol on time to tracheal extubation for isoflurane based general anesthesia

Introduction: To facilitate early emergence from general anaesthesia, monitored titration of inhalation anaesthetic is a necessity intra operatively. These monitored modalities may be Bispectral index (BIS) and end-tidal anaesthetic gas (ETAG) concentration Early tracheal extubation after general anaesthesia is a desirable goal as it is associated with decreased Intensive Care Unit (ICU), length of stay (LOS), hospital LOS, and thus, the potential for improved recovery and adequate or titrated resource utilisation. While intra operative anaesthetic techniques have made progress to accentuate fast track recovery, the role of brain monitoring in extubation has not been well studied. Bispectral index (BIS) monitoring has been used to monitor the depth of anaesthesia.Objectives: To study duration of recovery time from the depth of anaesthesia between both the groups and the haemodynamic response during tracheal extubation, in both groups.Methodology: A Comparative, Randomised, double blinded study was conducted on 60 adult patients undergoing elective surgeries under Isoflurane based general anaesthesia in Basaveshwara Medical College and Hospital, Chitradurga. Sampling is done by Simple Random Sampling using computer generated table with the duration of study was 18 months i.e. from August 2022, to February 2024,Therefore a sample size of 30 in each group is considered.Results: The duration of surgery, and anaesthesia are not significant, where as time of extubation is significant in BIS group with 5.16±0.65 (Mean and SD) with p value is < 0.005.Conclusion: In our study, comparing BIS with ETAG with isoflurane, the BIS group had early recovery and post extubation, BIS group 5.16±0.65 and ETAG 7.3±1.26 with p-value -0.0001, with haemodynamic stability in both group.