Comparison between Bispectral Index and Patient State Index as Measures of the Electroencephalographic Effects of Sevoflurane

Soehle, Martin; Ellerkmann, Richard K.; Grube, Matthias; Kuech, Matthias; Wirz, Stefan; Hoeft, Andreas; Bruhn, Joergen

doi:10.1097/aln.0b013e3181895fd0

Cited by 68 publications

(65 citation statements)

References 27 publications

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“…Our results were similar to those reported in children whose K e0 value in the BIS was also greater than in the CSI, although the actual K e0 values of children are larger than those of adults [2,14] . Our mean individual K e0 value for the BIS was 0.36 min -1 , which is comparable to previously reported range (0.22-0.48 min -1 ) [15][16][17][18] . While it was expected that the administration of additional remifentanil might lead to an increase in k e0 [17] , the infusion dose of remifentanil did not seem to have much influence on the k e0 value.…”

Section: Discussionsupporting

confidence: 79%

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Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

et al. 2011

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Aim:The cerebral state index (CSI) was recently introduced as an electroencephalographic monitor for measuring the depth of anesthesia. We compared the performance of CSI to the bispectral index (BIS) as electroencephalographic measures of sevoflurane effect using two combined sigmoidal E max models. Methods: Twenty adult patients scheduled for laparotomy were studied. After induction of general anesthesia, sevoflurane concentrations were progressively increased and then decreased over 70 min. An analysis of the BIS and CSI with the sevoflurane effect-site concentration was conducted using two combined sigmoidal E max models. Results: The BIS and CSI decreased over the initial concentration range of sevoflurane and then reached a plateau in most patients. A further increase in sevoflurane concentration produced a secondary plateau in the pharmacodynamic response. The CSI was more strongly correlated with effect-site sevoflurane concentration (R 2 =0.95±0.04) than the BIS was (R 2 =0.87±0.07) (P<0.05). The individual E max and C eff50 (effect-site concentration associated with 50% decrease from baseline to plateau) values for the upper and lower plateaus were significantly greater for BIS (12.7±7.3, 1.6±0.4, and 4.2±0.5, respectively) than for CSI (3.4±2.2, 1.2±0.4, and 3.8±0.5, respectively) (P<0.05). The remaining pharmacodynamic parameters for the BIS and CSI were similar. Conclusion: The overall performance of the BIS and CSI during sevoflurane anesthesia was similar despite major differences in their algorithms. However, the CSI was more consistent and more sensitive to changes in sevoflurane concentration, whereas the measured BIS seemed to respond faster. The newly developed combined E max model adequately described the clinical data, including the pharmacodynamic plateau.

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Section: Discussionsupporting

confidence: 79%

“…The C eff501 and λ 1 may correspond to the C eff50 and λ in data that exclude the burst suppression or deep anesthetic condition. The C eff501 and λ 1 of the BIS in our study were somewhat greater than the C eff50 and λ in previously published research [16,18] . However, our results may be more common from a clinical point of view.…”

Section: Discussioncontrasting

confidence: 43%

Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

et al. 2011

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“…[28,29] Our BIS results may have varied from actual values. For example, the BIS value observed at the loss of eyelash reflex could have been higher than the actual value.…”

Section: Discussionmentioning

confidence: 99%

The utility of bispectral index monitoring for prevention of rocuronium-induced withdrawal movement in children

et al. 2017

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Background:This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children.Methods:Finally, 135 healthy children (3–12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0.6 mg/kg was administered at the loss of eyelash reflex; in the 1st experimental group, rocuronium 0.6 mg/kg was administered when BIS fell to less than 40 (group T; n = 45); however, if BIS did not fall below 40 after thiopental sodium administration, manual ventilation was provided with oxygen 6 L/minute using sevoflurane 8% and then rocuronium was administered when BIS fell below 40 (the 2nd experimental group, group S; n = 45). Rocuronium-induced WM was evaluated using a 4-point scale (no movement; movement/withdrawal involving the arm only; generalized response, with movement/withdrawal of more than 1 extremity, but no requirement for restraint of the body; and generalized response which required restraint of the body and caused coughing or breath-holding).Results:No significant differences were found among the groups for patient characteristics including age, sex, height, and location of venous cannula. However, body weight, height, and body mass index in group S were all smaller than those in group T. The incidence of WM caused by rocuronium was 100% in group C, 95.6% in group T, and 80% in group S, and was significantly lower in group S than in group C. The grade of WM was 3.7 ± 0.6 in group C, 3.2 ± 0.9 in group T, and 2.6 ± 1.0 in group S. It was significantly lower in group T than in group C and significantly lower in group S than in groups C and T.Conclusion:The confirmation of a deep hypnotic state with BIS values lower than 40 using BIS monitoring can reduce the grade of rocuronium-induced WMs during anesthesia induction using thiopental sodium or sevoflurane in children.

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“…The authors of a study evaluating the BIS and patient state index (PSI derived from SEDLine Monitor, Hospira Inc., Lake Forest, Illinois, USA) with simultaneous monitoring reported a prediction probability (P k ) to predict sevoflurane effect-site concentration for a BIS of 0.80 AE 0.11 and PSI of 0.79 AE 0.09 [28]. This P k indicates that, in 100 changes in depth of anesthesia (regardless of whether it was an increase or decrease), BIS would correctly indicate the change in 80 cases and PSI would correctly indicate the change in 79.…”

Section: Comparison Of Monitorsmentioning

confidence: 99%

Depth of anesthesia

Kent

Domino

2009

Current Opinion in Anaesthesiology

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Comparison between Bispectral Index and Patient State Index as Measures of the Electroencephalographic Effects of Sevoflurane

Cited by 68 publications

References 27 publications

Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

Comparison between cerebral state index and bispectral index as measures of electroencephalographic effects of sevoflurane using combined sigmoidal Emax model

The utility of bispectral index monitoring for prevention of rocuronium-induced withdrawal movement in children

Depth of anesthesia

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