DYNAMICS OF BISPECTRAL INDEX VALUES DURING THE MAIN STAGES OF SURGICAL INTERVENTION AND THEIR CLINICAL INTERPRETATION

The aim of this study was to evaluate the clinical significance of Bispectral Index (BIS) monitoring for objective assessment of anesthesia depth in children undergoing surgical correction of congenital heart defects under cardio­pulmonary bypass. The effectiveness of BIS monitoring was analyzed at different stages of surgery, including the assessment of episodes of excessive and insufficient anesthesia depth as well as the risk of intraoperative awareness. The findings demonstrated that BIS monitoring enabled maintenance of the target anesthesia range (BIS 40-60) during 87.3% of intraoperative time compared with 61.4% in the conventional monitoring group (p<0.001). The inci­dence of intraoperative awareness decreased from 9.5% to 1.6% (p=0.048). Induction and the rewarming phase after cardiopulmonary bypass were identified as the most critical stages regarding disturbances in anesthesia adequacy, requiring enhanced monitoring during these periods. The obtained results indicate the high informativeness and clinical efficacy of BIS monitoring in providing adequate anesthetic protection and improving the safety of pediatric cardiac surgery in children with congenital heart defects.