BISPECTRAL INDEX (BIS) MONITORING IN THE PERIOPERATIVE PERIOD DURING SURGICAL CORRECTION OF TETRALOGY OF FALLOT IN CHILDREN

Abstract

Tetralogy of Fallot (TOF) remains one of the most common cyanotic congenital heart defects requiring early surgical correction. Anesthetic management in these patients is particularly challenging due to unstable hemodynamics, right-to-left shunting, hypoxemia, and the risk of hypercyanotic spells, all of which complicate accurate assessment of anesthesia depth using conventional clinical criteria alone. Inadequate depth of anesthesia may provoke intraoperative awareness, hemodynamic instability, and increased catecholamine release, whereas excessive anesthetic depth may aggravate myocardial depression in an already compromised cardiovascular system.