Is the Bispectral Index Useful in Predicting Fast-Track Eligibility After Ambulatory Anesthesia with Propofol and Desflurane?

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This study was designed to test the hypothesis that outpatients with higher electroencephalographic (EEG) Bispectral Index (BIS) values at the end of anesthesia achieve a modified Aldrete score of 10 and satisfy fast-track eligibility criteria more rapidly after ambulatory surgery. Sixty consenting women undergoing laparoscopic tubal ligation procedures were studied. After premedication with midazolam 2 mg IV, anesthesia was induced with propofol 2 mg/kg IV, fentanyl 1.5 [micro sign]g/kg IV, and succinylcholine 1 mg/kg IV and was initially maintained with either desflurane 4% (n = 31) or a propofol infusion 100 [micro sign]g [center dot] kg-1 [center dot] min-1 (n = 29), in combination with nitrous oxide 65% in oxygen. Subsequently, the inspired desflurane concentrations (2%-6%) and propofol infusion rates (50-150 [micro sign]g [center dot] kg-1 [center dot] min-1 were varied to maintain a clinically acceptable depth of anesthesia. The average BIS value during the 3-min interval immediately before the discontinuation of the maintenance anesthetics was recorded. Emergence times and modified Aldrete scores were assessed from the end of anesthesia until patients were considered fast-track-eligible. The BIS values at the end of anesthesia were significantly correlated with the time to reach fast-track eligibility in both the desflurane (r = -0.68) and propofol (r = -0.76) groups. We concluded that the EEG-BIS value at the end of anesthesia is useful in predicting fast-track eligibility after laparoscopic tubal ligation procedures with either a desflurane- or propofol-based anesthetic technique. Implications: In outpatients receiving either desflurane and propofol anesthesia for laparoscopic tubal ligation surgery, the times to achieve criteria for bypassing the recovery room (i.e., fast-tracking) correlated with the electroencephalo-graphic-Bispectral Index values at the end of anesthesia.(Anesth Analg 1998;87:1245-8)

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