Bispectral Index Monitoring (BIS) as a Guide for Intubation Without Neuromuscular Blockade in Office‐Based Pediatric General Anesthesia: A Retrospective Evaluation

摘要

The Bispectral Index System is a useful guide for timing of adequate intubationnconditions in office-based pediatric general anesthesia without neuromuscularnblockade. As the number of cases in the office-based setting increase, manyclini-ncians opt to intubate patients without neuromuscular blockade to avoid airwayncomplications associated with skeletal muscle relaxation. Conventionally, thisntechnique is conducted using the traditional monitoring criteria of vitalsigns,nend-tidal inhalation agents, as well as anesthesiologist timing and knowledge ofnthe pharmacodynamics of the anesthetic agent to help determine the properndepth of anesthesia for adequate intubating conditions.This study retrospectivelynassesses the use of the Bispectral Index System (BIS) as a guide for timing ofnnonparalytic tracheal intubation in pediatric office-based general anesthesia. An-nesthetic records for 168 children, American Society of Anesthesiology physicalnstatus I and II, and ranging in age from18 months to17 years were retrospectivelynanalyzed. Intubation outcomes were based on 6 preset criteria to reflect the ade-nquacy of the technique. The mean BIS value during the time of intubation wasn34.7. There were no complications encountered. A BIS mean value of 34.7 pro-nvided adequate intubation conditions without muscle relaxation in office-basednpediatric anesthesia without complications.