Acceptability of auricular vs frontal bispectral index values

Brown, Bryon Wm.; Edwards, Melannie; Tay, Shian Chao

doi:10.1093/bja/aeu244

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Another study by Brown et al [ 22 ] collected 1812 paired readings from 16 patients. Showed 95% limits of agreement ranged between − 17.6 and + 33.1 and a 0.8% incidence of potential awareness (BIS > 60) measured by the frontotemporal approach which was not picked up by the auricular approach.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries

Abdelrahman,

Elbadry,

Omara

2023

BMC Anesthesiol

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Background The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in individual patients undergoing renal surgeries while lateral positions at various stages of anesthesia. Patients and methods 12 patients older than 18 years, ASA I-III patients scheduled for elective renal operations, two BIS were placed on each patient, one on each side of the post-auricular region and one across the forehead, and each sensor was connected to a different BIS monitor. We gathered three pieces of data at each of the six-time points: BIS score, signal quality index (SQI) score calculating the signal’s strength and electromyography (EMG) score: before the onset of anesthesia (awake) when the eyelash reflex is lost (LOC), after intubation (intubation), following the initial surgical incision, each 30 min throughout the procedure (maintenance), and at the moment the patient’s eyes open naturally after waking up from anesthesia (emergence). Results The overall BIS value at the frontal position was significantly higher than the post-auricular position (52.5 ± 22.2 and 52.1 ± 22.1, respectively, P = 0.010). On the other hand, the BIS value was comparable between the frontal and post-auricular positions at LOC, intubation, 60, 120, and 80 min and at emergence. A strong link between the two sensor positions, as indicated by the correlation coefficient (r = 0.607, P < 0.001), and the Bland-Altman analysis revealed a small mean difference (-1.8) and a low (9.0/- 12.5) limit of agreement, with just 4.3% of the readings falling outside of it during the anesthetic maintenance period. Conclusion Acceptable variation in BIS data was observed when obtained from the two different sensor positions for clinical usage. The post-auricular BIS sensor system may be a suitable substitute for an impractical frontal setup. Protocol Registration The study was registered in clinicaltrials.gov on 11/07/2022 (trial registration number: NCT05451823).

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Section: Discussionmentioning

confidence: 99%

“…Using the auricular approach not only increases the risk of not detecting awareness, but also under-estimates the depth of anesthesia by a larger margin. This could potentially lead to unnecessarily increasing the depth of anesthesia, then increased risk of morbidity and mortality [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries

Abdelrahman,

Elbadry,

Omara

2023

BMC Anesthesiol

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“…This device enables BIS monitoring by collecting EEG signals from the forehead, even with limited space due to clinical situations. BIS monitoring has been investigated to place elsewhere, such as nasal [ 8 ], occipital [ 5 , 9 ], auricular [ 10 , 11 ], or mandibular [ 12 ] areas, and demonstrated a reasonable correlation, with the best concordance by the nasal dorsum measurement [ 8 ]. However, BIS has been considered to be topographically dependent [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of BIS monitoring using a novel interface device connecting conventional needle-electrodes and BIS sensors during frontal neurosurgical procedures

et al. 2021

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Background Bispectral index (BIS) monitoring is a widely used non-invasive method to monitor the depth of anesthesia. However, in the event of surgeries requiring a frontal approach, placement of the electrode may be impossible at the designated area to achieve a proper BIS measurement. Methods We developed an investigational interface device to connect needle-electrodes to BIS sensors. The safety and clinical performance were investigated in patients who underwent surgery. Direct BIS values from a disposable BIS electrode and indirect values via the interface device were simultaneously recorded from the same areas of electrode placement in a single patient. The agreement between the direct and indirect BIS values was statistically analyzed. Results The interface device with a silver electrode demonstrated sufficient electric conduction to transmit electroencephalogram signals. The overall BIS curves were similar to those of direct BIS monitoring. Direct and indirect BIS values from 18 patients were statistically analyzed using a linear mixed model and a significant concordance was confirmed (indirect BIS = 7.0405 + 0.8286 * direct BIS, p<0.0001). Most observed data (2582/2787 data points, 92.64%) had BIS unit differences of 10 or less. Conclusions The interface device provides an opportunity for intraoperative BIS monitoring of patients, whose clinical situation does not permit the placement of conventional adhesive sensors at the standard location.

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Appearance of an electrocardiogram tracing on a bispectral index monitor with plausible BIS values

Suzuki

Kimura

Shinoda

2015

J Clin Monit Comput

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Acceptability of auricular vs frontal bispectral index values

Cited by 3 publications

References 4 publications

Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries

Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries

Accuracy of BIS monitoring using a novel interface device connecting conventional needle-electrodes and BIS sensors during frontal neurosurgical procedures

Appearance of an electrocardiogram tracing on a bispectral index monitor with plausible BIS values

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