Bispectral index is a topographically dependent variable in patients receiving propofol anaesthesia

Pandin, Pierre; Cutsem, N. Van; Tuna, Turgay; D’Hollander, Alain

doi:10.1093/bja/ael235

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…20 This is in accordance with our study results of a consistent occipital/frontal bias of ϩ10 BIS units. They also found weak frontal-central correlation (r 2 ϭ 0.374) and moderate frontal-parietal correlation (r 2 ϭ 0.66), 20 which was also comparable with our moderate frontal/occipital correlation (r 2 ϭ 0.671) during anesthesia maintenance.…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, Pandin et al 20 demonstrated, in patients receiving graded increases in propofol target controlled infusion, that BIS A-1000 (version 3.12) exhibited consistently central/frontal bias of ϩ12 and parietal/frontal bias of ϩ25 BIS units. 20 This is in accordance with our study results of a consistent occipital/frontal bias of ϩ10 BIS units. They also found weak frontal-central correlation (r 2 ϭ 0.374) and moderate frontal-parietal correlation (r 2 ϭ 0.66), 20 which was also comparable with our moderate frontal/occipital correlation (r 2 ϭ 0.671) during anesthesia maintenance.…”

Section: Discussionmentioning

confidence: 84%

“…19,20 Hall and Lockwood 19 using BIS A-1000 (version 2.51) in patients undergoing a variety of anesthetic regimes demonstrated that data generated from the central locations were approximately ϩ13 BIS units higher than those derived from the frontal locations. Similarly, Pandin et al 20 demonstrated, in patients receiving graded increases in propofol target controlled infusion, that BIS A-1000 (version 3.12) exhibited consistently central/frontal bias of ϩ12 and parietal/frontal bias of ϩ25 BIS units. 20 This is in accordance with our study results of a consistent occipital/frontal bias of ϩ10 BIS units.…”

Section: Discussionmentioning

confidence: 99%

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BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia

et al. 2010

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We demonstrated that not only the regional limits of agreement are too wide to allow data of the two montages to be used interchangeably but also the variation is a function of anesthetic depth. However, keeping in mind a relatively consistent BIS-Vista -10 bias before induction and +10 bias during anesthesia maintenance with limits of agreement of approximately +/-11 BIS units, approximately double the clinically acceptable less than 10 BIS units level of agreement, BIS-Vista off-label occipital montage might be helpful in following a trend of propofol-remifentanil anesthesia in individual cases where frontal access is particularly difficult.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia

et al. 2010

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“…Secondly, it is possible that discrepancies in the predictive ability of the Marsh pharmacokinetic model for plasma propofol may compromise the study. However, previous studies have not demonstrated systematic inaccuracies in the Marsh model in a patient population comparable to our study group [15]. Moreover, the sequences of changes in EtCO 2 were randomised and would have negated inaccuracies created by the Marsh model.…”

Section: Discussionmentioning

confidence: 67%

The influence of changes in end‐tidal carbon dioxide upon the Bispectral Index*

2008

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Summary Carbon dioxide is known to affect consciousness in animals and humans. We surmised that changes in end‐tidal carbon dioxide during anaesthesia might affect the Bispectral Index. Twenty‐four patients due to undergo surgery were anaesthetised with fentanyl and a propofol infusion. The Bispectral Index, pulse rate and blood pressure were recorded while end‐tidal carbon dioxide levels were changed. The patients acted as their own controls as they were subjected to high, normal and low levels of end‐tidal carbon dioxide (3–12 kPa) according to a randomised sequence. There were no changes in the Bispectral Index or haemodynamic variables resulting from manipulation of the end‐tidal carbon dioxide. At the level of hypnosis involved in this study, changes in end‐tidal carbon dioxide, within the range tested, do not result in changes in the Bispectral Index.

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“…The complexity of the CNS lies probably not only in its structural complexity but also in its spatial and temporal metabolic and functional variability in either awake or comatose/unconscious patients, under anesthesia or in ICU [18]- [25]. To take that into account, neuro-monitoring has not to be too excessively simplified [26]- [28] and limited only to the forehead, as accurately described by John in his "anaesthetic cascade" [19].…”

Section: Temporal Topographical and Spatial Variations: The Brain Mmentioning

confidence: 99%

Monitoring Brain and Spinal Cord Metabolism and Function

Pandin¹,

Renard²,

Bianchini³

et al. 2014

OJAnes

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Monitoring the metabolism and function of the central nervous system not only is an old idea but also is a topic that is of increasing interest to the technological evolution. Beside the optimization of cerebral and spinal cord perfusion and the preservation of vasoreactivity to ensure the viability of cerebral tissues and structures, we want to know more and more about the real intimate situation of these organs in real time at the patient's bedside. To this end, several tracks have been explored during the two last decades, leading to the development of numerous concepts and the conception of various monitoring systems. One of the main problems is to characterize the respective strong points and weaknesses of those ones and to conclude regarding their individual relevance and value in current clinical practice. It is more and more clear that the combination of different categories of monitoring is a way to try to find the most valuable technological compromise, to increase the chance of prediction or of early detection of intercurrent deleterious events corresponding to the concept of multimodality. The intraoperative period and the intensive care goals and targets are appreciably different. This is the reason for the attempt to define different and distinct sets of goals and targets for the intraoperative anesthetic setting and for the intensive care unit.

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Bispectral index is a topographically dependent variable in patients receiving propofol anaesthesia

Abstract: The present results provide evidence that BIS index is a topographically dependent variable in patients receiving propofol anaesthesia.

Cited by 13 publications

References 17 publications

BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia

BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia

The influence of changes in end‐tidal carbon dioxide upon the Bispectral Index*

Monitoring Brain and Spinal Cord Metabolism and Function

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