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Abstract

Background & objective: Bispectral Index (BIS) monitoring is widely used to optimize anesthetic depth, but its impact on perioperative recovery outcomes in obese patients undergoing laparoscopic surgery remains unclear. This study evaluates the role of BIS monitoring in postoperative recovery, anesthetic consumption, and hemodynamic stability in this population.
Specifically, this study aimed to determine whether BIS monitoring reduces anesthetic consumption, shortens recovery times, improves hemodynamic stability, and enhances patient satisfaction compared to standard anesthesia management.
Methodology: This prospective, randomized controlled trial included 130 obese patients (BMI ≥ 30 kg/m²) undergoing laparoscopic cholecystectomy, hernia repair, or sleeve gastrectomy. The patients were randomized into BIS-monitored (n = 64) and Non-BIS (n = 66) groups. Anesthesia was maintained using sevoflurane or desflurane, with BIS titrated to 40–60 in the BIS group. Primary outcomes included time to emergence, time to extubation, and the Post-anesthesia Care Unit (PACU) stay. Secondary outcomes assessed anesthetic consumption, hemodynamic stability, postoperative complications, and patient satisfaction.
Results: BIS monitoring significantly reduced time to extubation (11.56 ± 4.29 vs. 12.80 ± 4.40 min, p = 0.025) and PACU stay (59.00 ± 17.65 vs. 60.95 ± 17.32 min, P = 0.041). No significant differences were observed in MAP, HR, or anesthetic consumption (P > 0.05). Postoperative complications were comparable between groups, but patient satisfaction scores were slightly higher in the BIS group (8.35 ± 1.60 vs. 7.90 ± 1.88, P = 0.078).
Conclusion: BIS monitoring significantly improves postoperative recovery by reducing extubation time and PACU stay, but does not significantly alter intraoperative hemodynamic stability or anesthetic consumption. These findings suggest that BIS monitoring may enhance postoperative recovery in obese patients undergoing laparoscopic surgery. Further research is needed to assess its impact in more complex surgical settings.
Abbreviations: BIS: Bispectral Index. BMI: Basal metabolic rate. PACU: Post-anesthesia Care Unit, PONV: postoperative nausea and vomiting
Keywords: BIS monitoring; Obesity; Laparoscopic Surgery; Postoperative Recovery; Anesthetic Consumption; Hemodynamic Stability
Citation: Gnanasigamani JP, Balasubramanian A, Rathnasabapathy B, Periasamy N, Periasamy P, Choudhary AK. Influence of BIS monitoring, obesity severity, and anesthetic agents on recovery outcomes in obese patients undergoing laparoscopic surgery: a multivariate analysis. Anaesth. pain intensive care 2025;29(3):665-673. DOI: 10.35975/apic.v29i3.2762
Received: February 26, 2025; Revised: March 14, 2025; Accepted: March 22, 2025