BJA Advance Access published online on October 29, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aei013
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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1 Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Germany
* To whom correspondence should be addressed. Background. This study was designed to investigate the impact of bispectral index (BIS) or A-line AAI index (based on middle-latency auditory evoked potential) monitoring on recovery times and drug consumption when compared with standard anaesthetic practice during desflurane-remifentanil anaesthesia. Methods. After having obtained approval from the institutional review board and written informed consent, 200 adult patients undergoing minor surgical procedures were randomized to receive a desflurane-remifentanil anaesthetic controlled either solely by clinical parameters or by BIS or AAI to the following target values: during maintenance of anaesthesia to a value of ‘50’ (BIS) or ‘30’ (AAI), 15 min before the end of surgery to ‘60’ (BIS) or ‘45’ (AAI). Recovery times and drug consumption were recorded by a blinded investigator. Results. Compared with standard practice, patients with BIS or AAI monitoring needed similar desflurane concentrations (standard practice 2.9 [0.5] vol%, BIS 3.3 [0.9] vol%, AAI 2.6 [0.5] vol%), and had similar recovery times (open eyes 5.6 [2.5] min, 5.9 [3.4] min, 5.0 [3.1] min; extubation 6.3 [2.4] min, 6.6 [3.5] min, 5.6 [3.0] min; stating name 7.3 [2.4] min, 7.6 [3.5] min, 7.3 [6.6] min). Conclusions. Compared with standard anaesthetic practice BIS and AAI guided titration to the used target ranges did not result in a reduction of desflurane consumption or recovery times during minor surgery with use of remifentanil.
Clinical Investigation
Bispectral index and A-line AAI index as guidance for desflurane-remifentanil anaesthesia compared with a standard practice group: a multicentre study
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2 Department of Anaesthesiology and Intensive Care Medicine, University of Saarland, Homburg/Saar, Germany
3 Department of Anaesthesiology and Intensive Care Medicine, University of Hamburg-Eppendorf, Hamburg, Germany
4 Department of Anaesthesiology and Intensive Care Medicine, University of Frankfurt, Germany
5 Department of Anaesthesiology and Intensive Care Medicine, St-Marien-Hospital, Lünen, Germany
J. Bruhn, E-mail: jbruhn{at}mailer.meb.uni-bonn.de
Abstract 
Declaration of interest: This study was supported by funding from Baxter, Inc., Germany.
This study was presented in part at the European Society of Anaesthesiologists meeting, 2004, Lisbon, Portugal.
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