ABSTRACT
In the July 2000 issue of JBMS, a case of an extremely difficult endotracheal intubation was published. Due to unplanned extubation protocal that patient had developed life- threatening complications in the immediate postoperative period but eventually survived. Considering her difficult airway anatomy, specific instructions were given for her future hospitalization needs. Three years later, ignoring those instructions, the patient reported with labour pain at a peripheral hospital and once again suffered from airway compromise which proved fatal. Running Title: Fatal airway disaster
Subject(s)
Humans , Female , Disasters , Fatal OutcomeABSTRACT
The bispectral index [BIS] has been developed as a monitor of sedation in patients receiving anaesthetic and sedative drugs. BIS has been shown to correlate with responsiveness under sedation and anaesthesia with a variety of agents. This study was designed to compare BIS with clinical assessment of sedation during ERCP. Forty patients were divided into two equal groups: Group1: The sedation level monitored by clinical assessment. Group II: The sedation level monitored by BIS. The Patients in both group did not receive any premedication, and the procedure was started after sedating the patients with 0.1 mg/kg midazolan and I Mg/Kg fentany1. Additional doses of midazolam were given according to the level of sedation either guided by BIS or clinical assessment. All vital signs and sedation levels were monitored, the total does of sedation was calculated and the rate of recovery and operator's satisfaction rate were evaluated.There was a statistical significant difference between both groups regarding sedation duration, recovery rate, satisfaction rate and the total dose of sedative with nonsignificant difference in vital signs monitoring. There results demonstrate that BIS may be a valuable monitor for determining safe levels of sedation and improving operator satisfaction and patients safety during ERCP