Comparative study of concordance between bispectral index recordings obtained from the standard frontal and infra-orbital sensor position

Comparison of Bispectral Index Monitor Data Between Standard Frontal-Temporal Position and Alternative Nasal Dorsum Position in the Intensive Care Unit: A Pilot Study

“…Previous studies that evaluated alternative locations of the BIS monitor placement were performed in paralyzed patients under general anesthesia undergoing surgical procedures in the operating room. [8][9][10][11][12] Even with these optimal patient and environmental conditions, these studies vary in their findings of presence or lack of correlation of the BIS monitor placement at an alternative location and the standard location. The studies evaluating the alternative occipital region and the mandibular region under general anesthesia did not find correlation to the standard frontal location.…”

“…The studies evaluating the alternative occipital region and the mandibular region under general anesthesia did not find correlation to the standard frontal location 9,10 . Puente-Barbas et al 12 compared the standard frontal BIS montage with an alternative placement across the nose bridge in paralyzed patients under protocolized general anesthesia for laparoscopic abdominal surgery in the operating room. The authors found that in analyzing the “optimal readings” with SQI of 100 and standard montage BIS EMG of 30 or less and alternative montage BIS EMG of 25 or less, the difference between the sensors was minimal.…”

“…[3][4][5][6][7] If the standard forehead placement of the BIS is unable to be accessed, alternate sites for BIS monitor placement, including postauricular location, mandibular location, occipital region, and nasal montage/infraorbital position, have only been explored in the operating room. [8][9][10][11][12] Given that previous studies have found a correlation of the BIS nasal montage/infraorbital position to the BIS montage from the standard frontal-temporal position in patients under pharmacological sedation and paralysis in the operating theater, 11,12 this pilot study evaluated the same alternative positioning for BIS placement in the ICU. Establishing this correlation would give postoperative providers more flexibility in applying the BIS monitor to patients in the critical care setting.…”

“…Recently, there have been multiple studies that show the BIS monitor reduces oversedation in the intensive care unit (ICU) as well 3–7 . If the standard forehead placement of the BIS is unable to be accessed, alternate sites for BIS monitor placement, including postauricular location, mandibular location, occipital region, and nasal montage/infraorbital position, have only been explored in the operating room 8–12 . Given that previous studies have found a correlation of the BIS nasal montage/infraorbital position to the BIS montage from the standard frontal-temporal position in patients under pharmacological sedation and paralysis in the operating theater, 11,12 this pilot study evaluated the same alternative positioning for BIS placement in the ICU.…”