Glasgow Coma Scales and General Anesthesia

Study Overview
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Brief Summary
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The study evaluates the general anesthesia management with BIS monitorization in terms of hemodynamic stability, drug concentrations and drug consumption in patients who underwent surgery due to intracranial pathology and who were divided in three different GCS groups.

Detailed Description
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BIS monitoring is mostly used for anesthesia depth and sedation level follow-up, however it can also be used for monitoring consciousness after resuscitation of cases with acute brain injury and cardiac arrest. It is not always possible to monitor and objectively measure the changes in the level of consciousness in clinical practice. Therefore, device-based methods have been introduced in monitoring the state of consciousness. Bispectral index (BIS) monitoring may be preferred in follow up of the state of consciousness in critical patients such as those with acute brain injury, in terms of ease of use, ability to obtain numerical results and continuous monitoring. BIS monitoring is mostly used for follow up of anesthesia depth and sedation level, while it can also be applied for monitoring state of consciousness following resuscitation in cases with acute brain injury and cardiac arrest.In this study, we aimed to investigate general anesthesia management performed by bispectral index monitoring in patients who underwent surgery due to intracranial pathology and with different Glasgow Coma Scales.

Official Title
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The Effect of Glasgow Coma Scales on General Anesthesia in Neurosurgery Patients

Conditions
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Anesthesia Awareness

Intervention / Treatment
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* Device: Bispectral index (BIS) monitoring
* Drug: Sevoflurane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 and 65 years ASA II-III intracranial surgery Exclusion Criteria: Patients with additional disease (electrolyte impairment, uremia, etc.), liver and renal failure affecting consciousness level other than intracranial pathology

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group I=13-15 mildly injured<br>Patients were divided into 3 groups according to the Glasgow Coma Scores calculated before surgery. use of anesthetic agent were recorded during bispectral index (BIS) monitoring and anesthesia application. we used sevoflurane drug intraoperative. Group I (n=15)=13-15 mildly injured | Device: Bispectral index (BIS) monitoring<br>* When the patients were taken to the operation table, they were monitored with the BIS. we used sevoflurane drug<br>Drug: Sevoflurane<br>* we used sevoflurane drug at inoperative<br>|
| Active Comparator: Group 2 =9-12 moderately damaged<br>Patients were divided into 3 groups according to the Glasgow Coma Scores calculated before surgery.use of anesthetic agent were recorded during bispectral index (BIS) monitoring and anesthesia application. we used sevoflurane drug intraoperative. Group 2 (n=15)=9-12 moderately damaged | Device: Bispectral index (BIS) monitoring<br>* When the patients were taken to the operation table, they were monitored with the BIS. we used sevoflurane drug<br>Drug: Sevoflurane<br>* we used sevoflurane drug at inoperative<br>|
| Active Comparator: Group 3=3-8 severely damaged.<br>Patients were divided into 3 groups according to the Glasgow Coma Scores calculated before surgery. use of anesthetic agent were recorded during bispectral index (BIS) monitoring and anesthesia application. we used sevoflurane drug intraoperative. Group 3 (n=15)=3-8 severely damaged. | Device: Bispectral index (BIS) monitoring<br>* When the patients were taken to the operation table, they were monitored with the BIS. we used sevoflurane drug<br>Drug: Sevoflurane<br>* we used sevoflurane drug at inoperative<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| BIS, Consumption of the inhalation agents | Preoperative, intraoperative and postoperative BIS values were recorded. The total amount of opioid consumed was recorded from the infusion pump. | 200 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bispectral index, Glasgow Coma Scale, intracranial pathology