Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients
1Tugba Bezgin Ankara University, Faculty of Dentistry Department of Paediatric Dentistry O6500 Ankara-Turkey
DOI: 10.17796/jcpd.39.1.8882n41g55720155 Vol.39,Issue 1,January 2015 pp.291-296
Published: 01 January 2015
*Corresponding Author(s): Dag C E-mail: cetintugba@yahoo.com
Objective: The aim of this study was to compare the total medicament doses and recovery profiles of patients for whom Bispectral Analysis (BIS) monitor was used to monitor sedation. Study design: Thirty-four uncooperative paediatric patients aged 3-6 years who attended to the Department of Pediatric Dentistry for dental treatment were enrolled in the study. Patients were randomly divided into 2 groups of 17 patients each. Physiological variables including oxygen saturation, blood pressure and heart rate were recorded. In one group (BIS-monitored group), drugs were administered to maintain patients’ BIS values between 60-70, while the other group (Non-BIS-monitored Group) was not monitored using BIS. Data was evaluated by Chi-square, Mann Whitney U, Independent Samples t, Paired Samples t and Wilcoxon signed tests, with a p-value of <0.05 considered to be statistically significant. Results: There was no significant difference in total anesthetic doses, incidence of adverse events or recovery profiles of patients between non- BIS-monitored and BIS-monitored groups (p≯0.05). However, distinct correlation was determined among mean values of UMSS and BIS values (p<0.05). Conclusion: BIS represents no advantage over the current commonly accepted methods for monitoring sedation depth in children.
Bispectral index, deep sedation, pediatric patients
Dag C,Bezgin T,Özalp N,Gölcüklü Aydın G. Utility of Bispectral Index Monitoring during Deep Sedation in Pediatric Dental Patients. Journal of Clinical Pediatric Dentistry. 2015. 39(1);291-296.
1. Nathan JE. Managing behavior of precooperative children. Dent Clin North Am 39: 789-816, 1995.
2. Özer L, Öktem ZB, Küçükyavuz Z. Effects of deep sedation on behaviors and side effects in children undergoing different dental procedures. Pediatr Dent 33: 158-164, 2011.
3. Tsugayasu R, Handa T, Kaneko Y, Ichinohe T. Midazolam more effectively suppresses sympathetic activations and reduces stress feelings during mental arithmetic task than propofol. J Oral Maxillofac Surg 68: 590-596, 2010.
4. American Academy of Pediatric Dentistry. Guideline for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatr Dent 30: 143-159, 2008-2009.
5. Badina L, Norbedo S, Barbi E. Procedural sedation and analgesia in children. Lancet 10: 1900-1901, 2006.
6. Domino K. Depth of anesthesia: clinical applications, awareness, and beyond. IARS Review Course Lectures 2007.
7. Maranets I, Zeev KN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg 89: 1346-1351, 1999.
8. Messieha ZS, Ananda RC, Hoffman WE, Punwani IC, Koenig HM. Bispectral index system (BIS) monitoring reduces time to discharge in children requiring intramuscular sedation and general anesthesia for outpatient dental rehabilitation. Pediatr Dent 26: 256-260, 2004.
9. Sandler NA, Hodges J, Sabino M. Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis. J Oral Maxillofac Surg 59: 603-611, 2001.
10. Overly F, Wright R, Connor F, Jay G, Linakis JG. Bispectral analysis during deep sedation of pediatric oral surgery. J Oral Maxillofac Surg 63: 215-219, 2005.
11. Sandler NA. Additional clinical observations utiziling bispectral analysis. Anesth Prog 47: 84-86, 2000.
12. Morse Z, Kaizu M, Sano K, Kanri T. BIS monitoring during midazolam and midazolam-ketamine conscious intravenous sedation for oral surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94: 420-424, 2002.
13. Trouiller P, Fangio P, Paugam-Burtz C, et al. Frequency and clinical impact of preserved bispectral index activity during deep sedation in mechanically ventilated ICU patients. Intensive Care Med 35: 2096-2104, 2009.
14. Donaldson M, Goodchild JH. Use of bispectral index system (BIS) to monitor enteral conscious (moderate) sedation during general dental procedures. J Can Dent Assoc 75: 709. 2009.
15. Johansen JW, Sebel PS, Sigl JC. Clinical impact of hypnotic titration guidelines based on EEG bispectral index (BIS) monitoring during routine anesthetic care. J Clin Anesth 12: 433–443, 2000.
16. Liu S.S. Effects of bispectral index monitoring on ambulatory anesthesia. Anesthesiology 101: 311–315, 2004.
17. Singh H. Bispectral index (BIS) monitoring during propofol-induced sedation and anaesthesia. Eur J Anaesthesiol 16: 31-36, 1999.
18. Munoz Garcia J, Vidal Marcos AV, Restoy Lozano A, Gasco Garcia C. Utility of bispectral index monitoring during intravenous sedation in the dental office. Int J Oral Maxillofac Implants 27: 375-382, 2012.
19. Muńoz HR, Corti´Nez LI, Ibacache M.E, Leo´n PJ. Effect site concentrations of propofol producing hypnosis in children and adults: comparison using the Bispectral Index. Acta Anaesthesiol Scand 50: 882–887, 2006.
20. Giovannitti JA. Dental anesthesia and pediatric dentistry. Anesth Prog 42: 95-99, 1995.
21. Haberland CM, Baker S, Liu H. Bispectral index monitoring of sedation depth in pediatric dental patients. Anesth Prog 58: 66-72, 2011.
22. Overly FL, Wright RO, Connor AF, Fontaine B, Jay G, Linakis JG. Bispectral analysis during pediatric procedural sedation. Pediatr Emerg Care 21: 6-11, 2005.
23. McDermott NB, VanSickle T, Motas D, Friesen RH. Validation of the bispectral index monitor during conscious and deep sedation in children. Anesth Analg 97: 39–43, 2003.
24. Religa ZC, Wilson S, Ganzberg SI, Casamassimo PS. Association between bispectral analysis and level of conscious sedation of pediatric dental patients. Pediatr Dent 24: 221-226, 2002.
25. Özen B, Malamed SF, Cetiner S, Özalp N, Özer L, Altun C. Outcomes of moderate sedation in paediatric dental patients. Aust Dent J 57: 144-150, 2012.
26. Maragakis GM, Musselman RJ, Ho CC. Reaction of 5 and 6 year olds to dental injection after viewing the needle: pilot study. J Clin Pediatr Dent 31: 28-31, 2006.
27. Malviya S, Voepel-Lewis T, Tait AR. A comparison of observational and objective measures to differentiate depth of sedation in children birth to 18 years of age. Anesth Analg 102: 389–394, 2005.
28. Karst M, Winterhalter M, Münte S, et al. Auricular acupuncture for dental anxiety: A randomized controlled trial. Anesth Analg 104: 295-300, 2007.
29. Fukayama H. Which is better- conscious sedation or deep sedation? Anesth Prog 42:100-102, 1995.
30. Cote CJ, Wilson S, Work Group on Sedation. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: an update. Pediatrics 118: 2587-2602, 2006.
31. Malviya S, Voepel-Lewis T, Tait AR, Merkel S, Tremper K, Naughton N. Depth of sedation in children undergoing computed tomography: validity and reliability of the University of Michigan Sedation Scale (UMSS). Br J Anaesth 88: 241-245, 2002.
32. Powers KS, Nazarian EB, Tapyrik SA, et al. Bispectral index as a guide for titration of propofol during procedural sedation among children. Pediatrics 115: 1666-1674, 2005.
33. Esen E, Üstün Y, Balcıoğlu YO, Alparslan ZN. Evaluation of patient-controlled remifentanil application in third molar surgery. J Oral Maxillofac Surg 63: 457-463, 2005.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.
Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.
JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.
Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.
BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Scopus: CiteScore 1.8 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Top