Bispectral Index versus the University of Michigan Sedation Scale in assessing sedation depth during pediatric drug-induced sleep endoscopy,Sleep and Breathing

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Bispectral Index versus the University of Michigan Sedation Scale in assessing sedation depth during pediatric drug-induced sleep endoscopy
Sleep and Breathing ( IF 2.1 ) Pub Date : 2024-03-18 , DOI: 10.1007/s11325-024-03022-3
Yongping Zheng ₁ , Bingrui Xiong ₁ , Aming Sang ₁ , Xiaorong Liu ₁ , Xinyi Li ₁ , Xuemin Song ₂

Affiliation

Background and purpose

Bispectral Index (BIS) and University of Michigan Sedation Scale (UMSS) were two commonly used methods of monitoring the sedation depth, but their correlation was not clear. The purpose of this study is to ascertain if BIS correlates with UMSS in determining the sedation level during pediatric drug-induced sleep endoscopy (DISE).

Methods

One-hundred children, aged 36–143 months, with ASA I~II grade, were enrolled. They were subject to general anesthesia for an elective adenotonsillectomy. Two drug regimens were used. After UMSS ≥ 3, the sites of airway obstructions were located by checking the supraglottic airway structures with a fibrous laryngoscope. UMSS scores, BIS values, electromyography (EMG), and signal quality indices (SQIs) were recorded at the pre-medication and pre-DISE baseline (T₀), 5 min subsequent to medication administration but prior to DISE initiation (T₁), 1 min after DISE was initiated (T₂), 1 min after DISE was completed (T₃), 1 min subsequent to tracheal intubation (T₄), 1 min following extubation (T₅), and 30 min past extubation (T₆).

Results

There were strong correlations between BIS monitor readings and UMSS scores for total and two regimens. Kappa values revealed moderate agreement between BIS and UMSS for total and two regimens. The agreement rates were 67.47% for the total, 61.43% for Regimen 1, and 73.42% for Regimen 2, respectively.

Conclusion

BIS correlates with UMSS in determining the sedation level during pediatric DISE for two regimens. BIS might serve as an appropriate indicator of sedation intensity when UMSS could not be used.

中文翻译：

双频指数与密歇根大学镇静量表在儿科药物诱导睡眠内窥镜检查期间评估镇静深度的比较

背景和目的

双频指数（BIS）和密歇根大学镇静量表（UMSS）是两种常用的镇静深度监测方法，但其相关性尚不明确。本研究的目的是确定 BIS 是否与 UMSS 相关，以确定儿科药物诱导睡眠内窥镜检查 (DISE) 期间的镇静水平。

方法

纳入100名年龄36~143个月、ASA I~II级儿童。他们接受全身麻醉以进行选择性腺样体扁桃体切除术。使用两种药物方案。 UMSS≥3后，通过纤维喉镜检查声门上气道结构来定位气道阻塞部位。在用药前和 DISE 前基线 ( T ₀ )、用药后 5 分钟但 DISE 启动前 ( T ₁ ) 记录 UMSS 评分、BIS 值、肌电图 (EMG) 和信号质量指数 (SQI) 、DISE 启动后 1 分钟 ( T ₂ )、DISE 完成后 1 分钟 ( T ₃ )、气管插管后 1 分钟 ( T ₄ )、拔管后 1 分钟 ( T ₅ ) 和拔管后 30 分钟 ( T ) ₆ ).