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Effect of Head-Up Positioning on Bispectral Index and Recovery Profiles in Patients Undergoing Laparoscopic Hysterectomy: A Randomized Controlled Clinical Trial | ||
| Iranian Journal of Colorectal Research | ||
| مقاله 2، دوره 14، شماره 1، خرداد 2026 اصل مقاله (668.82 K) | ||
| نوع مقاله: Research/Original Article | ||
| شناسه دیجیتال (DOI): 10.30476/acrr.2026.110576.1283 | ||
| نویسندگان | ||
| fateme ahmadi* ؛ Mohammad yousofi؛ Zahra Honarvar؛ Roya Basirat | ||
| Clinical Research Development Unit, Mehrgan Hospital, Kerman University of Medical Sciences, Kerman, Iran | ||
| چکیده | ||
| Background: Patient positioning during laparoscopic surgery can affect respiratory, cardiovascular, and cerebral physiology, thereby influencing processed electroencephalographic measures of anesthetic depth. This study evaluated the effect of head-up positioning on intraoperative bispectral index (BIS) values and perioperative recovery outcomes in patients undergoing laparoscopic hysterectomy. Methods: In this randomized controlled clinical study, 105 adult patients undergoing elective laparoscopic hysterectomy were randomly assigned to either standard positioning (control, n=47) or approximately 30° head-up positioning (n=58). Anesthesia was induced with fentanyl, propofol, and atracurium and maintained with isoflurane at 1.2 MAC. The primary outcome was the mean intraoperative BIS. Secondary outcomes included measures of emergence, recovery, respiratory function, intra-abdominal pressure, sedation, and pain. Continuous variables were analyzed using independent-samples t-tests or Mann–Whitney U tests, as appropriate. ANCOVA was used to assess between-group differences in mean BIS after adjusting for age. Results: The mean intraoperative BIS was significantly lower in the head-up group compared to the control group (45.46±6.27 vs. 50.18±4.55; P<0.001). This difference remained significant after adjusting for age (F(1,101)=17.574, P<0.001; partial η²=0.148), with an adjusted between-group difference of −4.556 BIS units. The time to reach a BIS of 80 was shorter with head-up positioning (13.2±2.8 vs. 15.4±3.2 minutes; P=0.028). The duration of anesthesia was longer in the head-up group (67 vs. 55 minutes; P=0.017), whereas surgery duration was similar between groups (P=0.729). Extubation time, PACU stay, postoperative pain, ETCO₂, mean airway pressure, and intra-abdominal pressure did not differ significantly between groups. RASS scores differed significantly (P=0.036). Conclusion: Head-up positioning was associated with lower intraoperative BIS values during laparoscopic hysterectomy. However, without direct assessment of cerebral perfusion or oxygenation, these findings cannot conclusively indicate a greater depth of pharmacological hypnosis. Therefore, changes in BIS following positional interventions should be interpreted with caution. | ||
تازه های تحقیق | ||
Mohammad Yousofi (Google Scholar) Fatemeh Ahmadi (Google Scholar) | ||
| کلیدواژهها | ||
| Consciousness Monitors؛ Hysterectomy؛ Laparoscopy؛ Anesthesia, General؛ Anesthesia Recovery Period | ||
| مراجع | ||
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