Comparison of Richmond Agitation Sedation Scale (RASS) and Ramsay Sedation Scale (RSS) with Bispectral Index to Evaluate Depth of Sedation in Patients at The Intensive Care Unit in Adam Malik General Hospital Medan
Yulianda, Riza Stya
Nasution, Akhyar Hamonangan
Lubis, Fadli Armi
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Background: Management of sedation and analgesia in the Intensive Care Unit requires parameters to evaluate the sedation that can be done by objective or subjective methods. Objectively, we can use the Bispectral Index (BIS), while subjectively we can use thesedation scale, such as Richmond Agitation Sedation Scale (RASS) and Ramsay Sedation Scale (RSS). Objective: This study aims to compare the correlation between BIS with RASS and RSS. Method: Thirty-four patients who was treated in the Intensive Care Unit, mechanically ventilated and receiving Midazolam sedation with a cross-sectional analytic design were observed with BIS (target 65-85), then observed with RSS and RASS sedation scales. Patients with muscle relaxation treatment, central nervous system disorder, GCS <8, and unstable hemodynamics were included the exclusion criteria in this study. Results: The average value of Richmond Agitation Sedation Scale (RASS) was -0.88 and Ramsay Sedation Score (RSS) was 3.55 after the administration of sedation. The correlation of Bispectral Index when evaluating the depth of sedation in patients at Intensive Care Unit with the Richmond Agitation Sedation Scale (RASS) sedation scale showed a non-significant weak correlation (r = -0.232 p> 0.05) compared to the correlation of Ramsay Sedation Score (RSS) sedation scale to Bispectral Index (r = 0.350 p <0.05). Conclusion: RSS and RASS scoring systems had weak correlation to BIS but can be used to evaluate the depth of sedation in the Intensive Care Unit where RSS showed a better correlation than RASS.