The Effect of the Bispectral Index on Medication Utilization in the Operating Room and Time to Discharge from the Postanesthesia Care Unit

Abstract

Goal

To assess the effectiveness of the Bispectral Index (BIS) monitor in reducing hypnotic medication utilization, associated costs, and length of patient stay in the postanesthesia care unit (PACU).

Methods

The utilization and cost of inhaled anesthetics, induction agents, and time to discharge from the PACU before the introduction of BIS technology were evaluated retrospectively. The same data was then collected from patients whose level of consciousness was assessed using the BIS monitor.

Results

The mean total medication cost per patient case was $53.40 in the baseline group compared with $33.10 in the BIS group; when normalized to a 60-minute case, total costs per case were comparable. The mean cost of inhaled anesthetic per case in the baseline group was $19.47 compared with $8.14 in the BIS group; the normalized cost of inhaled anesthetic per case in the baseline group was $13.43 compared with $9.36 in the BIS group. The mean time to discharge from the recovery room was 68 minutes in the baseline group and 54 minutes in the BIS group. Cases were also categorized by length of procedure, and costs and times to discharge were tabulated for each category.

Conclusion

The BIS monitor appears to decrease the utilization and costs of hypnotic/induction agents. However, the cost of the BIS monitor is substantial and could ultimately offset the medication cost savings.