Journal of Behçet Uz Children's Hospital (Aug 2023)

Does Endotracheal Suctioning Affect Bispectral Index and Ramsay Sedation Scores in Pediatric Intensive Care Patients?

  • Gülhan Atakul,
  • Gökhan Ceylan,
  • Özlem Saraç Sandal,
  • Ferhat Sarı,
  • Sevgi Topal,
  • Mustafa Çolak,
  • Ekin Soydan,
  • Utku Karaarslan,
  • Rana İşgüder,
  • Hasan Ağın

DOI
https://doi.org/10.4274/buchd.galenos.2023.05547
Journal volume & issue
Vol. 13, no. 2
pp. 88 – 93

Abstract

Read online

Objective: A particular electroencephalography parameter known as the bispectral index (BIS) is one of the objective methods used to assess sedative and hypnotic effects. The aim of this study is to monitor the level of consciousness of patients who underwent sedation-analgesia in pediatric intensive care unit (PICU) and to evaluate how their sedation levels were affected by painful procedures by examining BIS and Ramsey Sedation Scale (RSS). Method: This prospective observational study was held 43 pediatric patients who were hospitalized in the 24-bed university-affiliated tertiary PICU. BIS, RSS and vital signs were recorded both before and after the endotracheal suctioning procedure. Patients were divided into two groups according to the chosen analgesic which was fentanyl or morphine. Percentage change (BIS, electromyography activity, signal quality index, RSS score, heart rate, oxygen saturation) of before/after endotracheal suctioning was calculated. Results: The increase in BIS value, increase heart rates and decrease RSS of patients with endotracheal suctioning were found to be significant (p<0.01, p=0.01, p<0.001 respectively). Percentage changes were compared between two groups and there was no significant difference between morphine and fentanyl group. Conclusion: Even in patients receiving strong analgesic agents like opioids, any painful procedures such as endotracheal suctioning increase the BIS values of the patients and disrupt their comfort. Continuous BIS value tracing may be more beneficial than clinical scoring systems on sedation monitoring and patient comfort. We also suggest further studies with different groups of analgesic agents should be conducted.

Keywords