Background: The anesthesia may require high doses of hypnotics to manage signs of
inadequate anesthesia or analgesia and its excessive use. The Bispectral Index (BIS)
monitoring may be helpful in the titration of anesthetic agents more accurate than what is
possible by standard clinical parameters. This study aimed to evaluate the value of the BIS
index in anesthesia monitoring. Methods: one hundred patients scheduled for various
elective surgical procedures were randomly allocated into two equal groups (n=50);
Propofol total intravenous anesthesia (TIVA) and Isoflurane inhalational anesthesia. Each
group is furtherly subdivided into two equal subgroups (n=25) according to whether BIS
monitoring guided titration of anesthetics was used or only standard clinical practice. The
results were assessed regarding; the consumption of anesthetics, recovery times and
postoperative complications and the results were analyzed statistically. Results: BIS
monitoring resulted in a lower Propofol infusion rate and lower end-tidal Isoflurane
concentration in the BIS subgroups. Also, BIS monitoring resulted in shorter recovery times
and less incidence of postoperative nausea and vomiting (PONV) in the BIS subgroups.
Conclusion: Using the BIS index in patients undergoing surgical procedures under general
anesthesia significantly decreases anesthesia consumption, improves recovery profile, and
decreases postoperative PONV