Impact of Bispectral Index Monitoring Versus Clinical Judgment as a Guide for Conduction of Anesthesia on Serum Cortisol Level in Coronary Artery Bypass Graft Surgery

Background: inadequate depth of anesthesia leads to releaseof stress hormones . electroencephalographic monitoring bybispectral index is a guide to asses the depth of anesthesia.the aim of the present study was to measure the serum cortisollevels as an index of stress response in patients who arecandidates for coronary artery bypass graft surgery in twogroups of patients .methods: seventy-six patients who were scheduled for primaryelective cardiopulmonary bypass were enrolled in a double-blind randomized study. the patients were divided intotwo groups , the infusion of anesthetic drugs was guided bybispectral index in group i (n=38) , and by clinical judgment ingroup ii (n=38). for all the patients the blood cortisol levelwas measured four times during operation.results: serum cortisol levels decreased during operation inboth groups, reaching 67.8% of the baseline in group i and63.2% of the baseline in group ii. there were no significantdifferences in mean serum cortisol levels between the twogroups (p<0.09). preoperatively, the mean blood cortisol levelwas 19.94 ug/dl in group 1 and 16.89 ug/dl in group ii whichreached to 10.48 ug/d: in group i and 6.42 ug/dl in group iipostoperatively. there was no significant difference betweentwo groups regarding bispectral index values.conclusions: it seems that monitoring of the patients byclinical judgment or bispectral index has equal influenceson serum cortisol levels during coronary artery bypass graftsurgery.