Comparison between cerebral state index and bispectral index during desflurane anesthesia

Abstract

BackgroundCerebral state index (CSI) is an anesthesia depth monitor alternative to bispectral index (BIS). Published comparative studies have used propofol or sevoflurane. However, studies using desflurane have not been reported yet. Different volatile anesthetics have different electroencephalography signatures. The performance of CSI may be different in desflurane anesthesia. Therefore, the objective of this study was to compare CSI and BIS during desflurane anesthesia.MethodsThirty-three patients were recruited. Desflurane and remifentanil were used to maintain general anesthesia. BIS and CSI were recorded simultaneously every minute. End-tidal concentration of desflurane was maintained at 4% from the beginning of surgery for 5 minutes. Pairwise data of CSI and BIS were obtained five times at one-minute intervals. This process was repeated in the order of 6%, 8%, and 10%.ResultsBIS and CSI were negatively correlated with the end-tidal concentration of desflurane with a similar degree of correlation (correlation coefficient BIS: –0.847, CSI: –0.844). The relationship between CSI and BIS had a good linearity with a slope close to 1 (R2 = 0.905, slope = 1.01). For the relationship between CSI and BIS at each end-tidal concentration of desflurane, CSI and BIS showed good linearity in 4% and 10% (R2 = 0.559, 0.540). However, the linearity and slope were decreased in 6% and 8% (R2 = 0.163, 0.014).ConclusionsCSI showed an equivalent degree of overall performance compared to BIS in desflurane anesthesia. Accounting for previous literature, CSI can be used as a good substitute for BIS regardless of the kind of anesthetics used.

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

“…Several studies have compared the performance of different EEG-derived monitors and other monitors in the patients. [6,14,22,23] Most of these studies reported comparable prediction probabilities for the different monitor types. In the present study, BIS and PSI yielded similar prediction probabilities for distinguishing the maintenance state from recovery state in children.…”

“…Although BIS was developed with adult EEG data, many studies have utilized the BIS to monitor anesthesia depth in children. [3] Now, we have several EEG-based monitors and indicators (e.g., Entropy, [4] Narcotrrend, [5] cerebral state index (CSI), [6] index of consciousness (IoC), [7] qCON, [8] A-line autoregression index (AAI), [9] brain anesthesia response (BAR) [10] and patient state index (PSI) [11]) in clinical practice. Many studies comparing the performance of these monitors have shown the comparable results between the monitors.…”

Comparison of bispectral index and patient state index during sevoflurane anesthesia in children: a prospective observational study

“…Several studies have compared the performance of different EEG-derived monitors and other monitors in the patients. [6,14,21,22] Most of these studies reported comparable prediction probabilities for the different monitor types. In the present study, BIS and PSI yielded similar prediction probabilities for distinguishing the steady state from recovery state in children.…”

“…[2] Although BIS was developed with adult EEG data, many studies have utilized the BIS to monitor anesthesia depth in children. [3] Now, we have several EEG-based monitors and indicators (e.g., Entropy, [4] Narcotrrend, [5] cerebral state index (CSI), [6] index of consciousness (IoC), [7] qCON, [8] A-line autoregression index (AAI), [9] brain anesthesia response (BAR) [10] and patient state index (PSI) [11]) in clinical practice, exhibiting comparable results in many studies.…”

Do you believe that processed EEG helps to prevent intraoperative awareness?

“…This month’s edition of the Korean Journal of Anesthesiology contains a paper focusing on the comparison between cerebral state index (CSI) and bispectral index (BIS) during desflurane anesthesia in which Cho et al [ 1 ] reported that CSI can be used as a good substitute for BIS, regardless of the kind of anesthetic used.…”