IS THE BISPECTRAL INDEX USEFUL IN PREDICTING FAST-TRACK ELIGIBILITY AFTER AMBULATORY ANESTHESIA WITH PROPOFOL AND DESFLURANE

This study was designed to test the hypothesis that outpatients with h igher electroencephalographic (EEG) Bispectral Index (BIS) values at t he end of anesthesia achieve a modified Aldrete score of 10 and satisf y fast-track eligibility criteria more rapidly after ambulatory surger y. Sixty consenting women undergoing laparoscopic tubal ligation proce dures were studied. After premedication with midazolam 2 mg IV, anesth esia was induced with propofol 2 mg/kg IV, fentanyl 1.5 mu g/kg IV, an d succinylcholine 1 mg/kg ni and was initially maintained with either desflurane 4% (n = 31) or a propofol infusion 100 mu g . kg(-1). min(- 1) (n = 29), in combination with nitrous oxide 65% in oxygen. Subseque ntly, the inspired desflurane concentrations (2%-6%) and propofol infu sion rates (50-150 mu g . kg(-1). min(-1) were varied to maintain a cl inically acceptable depth of anesthesia. The average BIS value during the S-min interval immediately before the discontinuation of the maint enance anesthetics was recorded. Emergence times and modified Aldrete scores were assessed from the end of anesthesia until patients were co nsidered fast-track-eligible. The BIS values at the end of anesthesia were significantly correlated with the time to reach fast-track eligib ility in both the desflurane (r = -0.68) and propofol (r = -0.76) grou ps. We concluded that the EEG-BIS value at the end of anesthesia is us eful in predicting fast-track eligibility after laparoscopic tubal lig ation procedures with either a desflurane- or propofol-based anestheti c technique. Implications: In outpatients receiving either desflurane and propofol anesthesia for laparoscopic tubal ligation surgery, the t imes to achieve criteria for bypassing the recovery room (i.e., fast-t racking) correlated with the electroencephalographic-Bispectral Index values at the end of anesthesia.