Comparing of the accuracy of BISpro index and Narcotrend index for evaluating depth of sedation during propofol anesthe-sia
Objective To compare the accuracy,correlation and consistency of BISpro index(BISpro)and Narcotrend index(NT)in evaluating the depth of propofol sedation.Methods A total of 30 female patients who undergoing elective hysteroscopic sur-gery,with American Society of Anesthesiologists(ASA)grade Ⅰ or Ⅱ,aged 18-55 years were enrolled in this study.Propofol sedation was induced by an initial target-controlled concentration of 1.0 mg/L,followed by a stepwise increase 0.5 mg/L every 2 min until the pa-tient was in unresponsive state.Their BISpro,NT,heart rate,target-controlled effect-site concentration(Ces)of propofol,and the Ob-server's Assessment of Alertness and Sedation(OAA/S)score were recorded every 30 s.BISpro and NT were compared between pa-tients with different OAA/S scores.The correlation coefficients of BISpro,NT,heart rate and Ces with OAA/S scores were calculated,and the correlation coefficient between BISpro and NT was calculated.Bland-Altman analysis was performed to evaluate the consisten-cy between BlSpro and NT.The differences in the prediction probability(PK)of BISpro,NT,heart rate and Ces for OAA/S score were compared.The optimal cut-off values of BISpro and NT for lost response were also calculated by the receiver operating characteristic(ROC)curve.Results Compared with those with OAA/S scores 3,4 and 5,decreased BISpro and NT were found in patients with OAA/S score≤2,with statistical differences(all P＜0.05).BISpro(r=0.761),NT(r=0.831)and Ces(r=0.884)were well correlated with OAA/S scores(all P＜0.001),and BISpro was positively related to NT(r=0.689,P＜0.001).The consistency limit between BISpro and NO was from-21.4 to 23.7,and the maximum difference was 20.The PK of BISpro for OAA/S score was 0.884,which was slightly low-er than NT(0.927),but significantly higher than Ces(0.768).Both BISpro and NT accurately predicted wakefulness and deep sedation(BISpro 0.909,NT 0.965),as well as wakefulness and loss of response(BISpro 1.000,NT 1.000),without statistical differences(both P＞0.05).However,the efficiency of both BISpro and NT in predicting wakefulness and light sedation was poor(BISpro 0.666,NT 0.796),which was remarkably lower than that of Ces(0.927).The optimal cut-off value of BISpro for lost response was 76,with a sensitivity of 100％,and a specificity of 84.9％,and the area under the curve(AUC)was 0.98(P＜0.05).The optimal cut-off value of NT for lost re-sponse was 67,with a sensitivity of 97.1％,and a specificity of 93.7％,and the AUC was 0.97(P＜0.05).Conclusions During propo-fol sedation,BISpro and NT have poor consistency and fail to accurately predict light sedation,but can accurately monitor the sedation degree of patients under general anesthesia.
BISpro indexNarcotrend indexPropofolDepth of sedation
NETL
NSTL
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