The effect of anesthetic management using bispectral index monitorization on postoperative agitation in pediatric anesthesia

The standard anesthesia protocol will consist of oral premedication with midazolam (0.5 mg/kg) followed by an inhaled induction with sevofurane 8% and placement of a peripheral IV cannula. Fentanyl 1 to 1.5 microgram/kg and rocuronium 0.5 to 0.6 mg/kg will be given before intubation. After intubation, the patients will be allocated into two groups randomly. Maintenance of anesthesia will be accomplished by titrating sevofurane (between 0.5% to 3.0%) in a background of 50% air in O2. The patients in Group 1 will receive routine anesthasia while the ones in Group 2 will receive anesthesia in an adjusted manner, with the BIS values between 45-55. Patients in Group 2 will be monitored with use of bispectral index and the level of anesthesia will be adjusted according to the results of the measurements. BIS monitorization will be carried out by the same anesthetist with minimum 5 years’ experience in pediatric anaesthesia, Bispectral Index Scale monitoring is used to prevent intraoperative awakening or awareness and to provide an accurate titration of the anesthesia agents to promote faster recovery from anesthesia. BIS monitoring involves for participants, small monitoring device placed across participant's forehead throughout procedure. Many clinical studies have shown that the administration of anesthetic agents under the guidance of BIS monitoring has allowed for more effective drug use, faster recovery from anesthesia, shorter time to extubation, and better recovery.. The BIS is displayed number between 0 and 100, with 45–55 being suitable for surgical anesthesia. Treating anaesthetist decides based on their clinical discretion how and by how much anaesthesia will be titrated if the BIS value drops out of the range of 45-55 Only patints in group 2 will be assessed with BIS.