| Abstrakt: |
Introduction: Sedation and analgesia are integral parts of patient care in intensive care units. These medications are routinely administered to mechanically ventilated patients to reduce pain, anxiety, improve patient comfort, to allow the patient to tolerate the physical environment and unpleasant procedures, avoiding awareness during ICU stay, reduce the requirement for the use of neuromuscular blocking agents and to contribute in maintaining metabolic and haemodynamic homeostasis. Materials and Methods: After approval by the Institutional ethical committee the study was conducted in the Main ICU of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. All the patients who were admitted in the main ICU were eligible for the study. After taking informed written consent, 70 adult patients who were haemodynamically stable and require sedation were studied. Patients were stabilized after admitting in the ICU. The demographic data including the admission diagnosis, admitting unit were collected. APACHE IIscore was calculated in first 24 hours. BIS electrodes were applied to the forehead of each patient after skin preparation to ensure low impedance and a good quality of signal. BIS offers continuous monitoring of sedation for 24 hours. Baseline BIS score and RSS, RASS scores were collected. Results: Seventy critically ill sedated patients were studied prospectively in MICU, PGIMER, Chandigarh. From January to December 2014. The mean patient age was 38.8 ± 16.5 years (range: 18- 92 years). 35 (50%) patients were male and 35 (50%) were female patients. The median APACHE score of the 70 patients was 11 with IQR of 8-13. Parameters like SBP, DBP, HR, SpO2, temperature; blood gases and electrolytes were assessed for normality by Shapiro Francia test. However, none of them showed normal distribution. The BIS, RSS, RASS of the patients during the study period are given in the table 1, and figures 1, 2, 3. Conclusion: We found significantly better correlation between RSS & RASS compared to RSS & BIS and RASS & BIS. This concludes that RSS and RASS are not a good substitute for BIS. Whereas RSS and RASS can be substituted each other. We found negligible correlation between BIS and clinical scores to APACHE. Hence we can conclude no influence of change in APACHE on BIS and clinical sedation scores (RSS and RASS). [ABSTRACT FROM AUTHOR] |
