Effect of a Course of Electroconvulsive Therapy on Interictal Bispectral Index Values

Thimmaiah, Rohini; Thirthalli, Jagadisha; Ramesh, Venkatapura J.; Radhakrishnan, Muthu Chellappan; Muralidharan, Kesavan; Mahadevaiah, Mahesh; Gangadhar, Bangalore N.; Gs, Rao

doi:10.1097/yct.0b013e318235b658

Cited by 12 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another aspect to be addressed is the baseline stability of BIS measurements in ECT courses. A recent study raised concerns on this issue by reporting that the initial BIS in awake patients before anesthesia lowered during the course of an ECT treatment [ 19 ] and thus challenged the validity of BIS monitoring in ECT courses.…”

Section: Bispectral Index Monitoring and Seizure Quality Optimizationmentioning

confidence: 96%

See 1 more Smart Citation

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

et al. 2013

View full text Add to dashboard Cite

In ECT, the relative timing of seizure induction and anesthesia may critically impact on seizure quality when anesthetic agents with anticonvulsive properties such as barbiturates or propofol are used. Measuring the depth of anesthesia by bispectral index (BIS) monitoring and thereby identifying the optimal moment for seizure induction might enhance seizure quality.Seizures from 869 individual ECT -sessions with thiopental anesthetic from 118 patients were examined in this retrospective study. The associations of the BIS value at the moment of seizure induction with 7 established seizure parameters and with a novel model of seizure quality were tested by regression analyses.BIS value at induction correlated positively with seizure duration, central inhibition, coherence and maximal heart rate, but not with midictal amplitude. Higher seizure quality was related with a higher BIS value at the moment of seizure induction.The BIS value at seizure induction serves as an independent predictor of seizure quality, influencing most other established markers. BIS monitoring appears as a simple tool to identify the optimal moment for seizure induction.

show abstract

Section: Bispectral Index Monitoring and Seizure Quality Optimizationmentioning

confidence: 96%

“…Therefore we conclude that the validity of BIS as a predictive marker for ECT effi cacy is not disturbed by baseline instability. In a study of Thimmaiah et al, the initial BIS of patients receiving bilateral ECT was lowered signifi cantly [ 19 ] . Our patients received unilateral ECT at the most, and their initial BIS did not drop over the course.…”

mentioning

confidence: 97%

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

et al. 2013

View full text Add to dashboard Cite

show abstract

“…[8] But with interictal BIS values being affected by ECT itself, BIS values considered adequate at one point may not be appropriate for subsequent ECT sessions during the later part of the treatment. [13] The merit of this study is that the age group of the patients is relatively low. Also, there were no patients with dementia.…”

Section: Discussionmentioning

confidence: 99%

Lower Bispectral index values in psychiatric patients: A prospective, observational study

Ramesh

Radhakrishnan

Thimmaiah

et al. 2014

Journal of Neuroanaesthesiology and Critical Care

Self Cite

View full text Add to dashboard Cite

Background: Bispectral index score (BIS) is a processed electroencephalographic parameter used to measure level of sedation in anaesthetised patients. In few studies of psychiatric patients undergoing electroconvulsive therapy (ECT), it was observed that the BIS values were lower at baseline. It is not clear from those studies whether the BIS values are really low. Also, it is not clear whether the lower values are related to the primary psychiatric illness or the due to the effect of ECT. Therefore, we studied the BIS values in psychiatric illnesses and compared them with the normal controls. Materials and Methods: BIS index was recorded in 237 patients with various psychiatric illness (Group P) and 40 control patients without any psychiatric illness undergoing spinal surgery (Group C). BIS values were recorded in supine position before breakfast and before the morning doses of antipsychotic/benzodiazepine medications. It was recorded during resting state in all the subjects. Results: BIS values were lower in group P compared to control group (a mean of 89.8 ± 7.8 vs 95.7 ± 2.4, P < 0.0001). In the group P, the patients with psychosis and bipolar disorder had significantly lower BIS values than the patients with depression ( P= 0.04). Conclusions: BIS values in psychiatric patients are lower than those in the control group. Psychotic and bipolar disorders are associated with significantly lower BIS values than the depression.

show abstract

“…Therefore, the AAI monitor may be an useful tool to determine a more precise timing for the electric shock of ECT. It has also reported that the BIS value that represents the awake state might become changed after the initial ECT [13]. In comparison, the AEP may be more resistant to the electroshock wave [14,15].…”

Section: Discussionmentioning

confidence: 99%

The Alaris auditory evoked potential monitor as an indicator of seizure inducibility and duration during electroconvulsive therapy: an observational study

Huang

Lin

et al. 2014

BMC Anesthesiol

View full text Add to dashboard Cite

BackgroundPrecise control of anesthetic depth during electroconvulsive therapy (ECT) is crucial because most intravenous anesthetics have anticonvulsant effects. In this study, we investigated the association between anesthetic depth measured by the Alaris auditory evoked potential index (AAI) and seizure inducibility and seizure duration during ECT.MethodsSixty-four ECTs were evaluated in 12 consecutive patients. General anesthesia was performed with a thiopental-based method. The relationship between the pre-ictal AAI, seizure activity and seizure duration was analyzed, and a possible threshold pre-ictal AAI to induce a seizure duration of at least 25 seconds was calculated.ResultsForty-one of the 64 ECT stimuli successfully induced seizure activity that lasted longer than 25 seconds. Pre-ictal AAI was significantly correlated to seizure duration (r = 0.54, p < 0.001) and the threshold pre-ictal AAi value was calculated to be 26 (area under curve: 0.76, sensitivity: 70.3% and specificity: 73.9%, p < 0.001). ECT with a pre-ictal AAI ≧ 26 had a higher incidence of successful seizure activity ( p < 0.001) and a longer seizure duration (55 ± 35 v.s. 21 ± 27 seconds, p < 0.001).ConclusionMaintenance of a pre-ictal AAI value ≧ 26 was associated with an increased incidence of successful seizure activities and a longer seizure duration. This is the first report to investigate Alaris AEP monitoring during ECT.

show abstract

Effect of a Course of Electroconvulsive Therapy on Interictal Bispectral Index Values

Cited by 12 publications

References 15 publications

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

Bispectral Index Monitoring and Seizure Quality Optimization in Electroconvulsive Therapy

Lower Bispectral index values in psychiatric patients: A prospective, observational study

The Alaris auditory evoked potential monitor as an indicator of seizure inducibility and duration during electroconvulsive therapy: an observational study

Contact Info

Product

Resources

About