Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-26T23:10:08.783Z Has data issue: false hasContentIssue false
  • English
  • Français

EEG-based indices of anaesthesia: correlation between bispectral index and patient state index?

Published online by Cambridge University Press:  23 December 2004

G. Schneider ,
A. Mappes ,
T. Neissendorfer ,
M. Schabacker ,
H. Kuppe  and
E. Kochs
G. Schneider
Affiliation:
Technische Universität München, Department of Anaesthesiology, Munich, Germany
A. Mappes
Affiliation:
Deutsches Herzzentrum, Institute of Anaesthesiology, Berlin, Germany
T. Neissendorfer
Affiliation:
Technische Universität München, Department of Anaesthesiology, Munich, Germany
M. Schabacker
Affiliation:
B. Braun Medical Inc., Bethlehem, PA, USA
H. Kuppe
Affiliation:
Deutsches Herzzentrum, Institute of Anaesthesiology, Berlin, Germany
E. Kochs
Affiliation:
Technische Universität München, Department of Anaesthesiology, Munich, Germany
Get access

Extract

Summary

Background and objective: Both the bispectral and the patient state indices are derived from the electroencephalogram and have been proposed as a measure of the same clinical target, the hypnotic component of anaesthesia. The present study evaluated whether there is concordance between the bispectral and the patient state indices with regard to end-points measured simultaneously in patients undergoing surgery under general anaesthesia.

Methods: Fifty-seven patients scheduled for elective abdominal, orthopaedic (Groups 1 and 2) or cardiac surgery (Group 3) under general anaesthesia were enrolled in the study. Anaesthesia was performed using remifentanil/sevoflurane (Group 1, 19 patients), remifentanil/propofol (Group 2, 19 patients) or sufentanil/propofol/isoflurane (Group 3, 19 patients). The bispectral and the patient state indices were simultaneously recorded. Pearson’s correlation between these two indices was calculated for the complete data and each group. The percentage of bispectral index values in the recommended range for general anaesthesia (45–60) that were confirmed by levels of patient state index (25–50) was calculated and vice versa.

Results: Overall correlation between the bispectral and the patient state indices was 0.667, 0.671 in Group 1, 0.650 in Group 2 and 0.675 in Group 3 (P < 0.01). For values of the bispectral index between 45 and 60, only 40% of corresponding patient state index values were between 25 and 50. For patient state index values of 25–50, only 50% of the corresponding bispectral index values were in the range of 45–60.

Conclusions: Concordance between the bispectral and patient state indices is relatively weak, whereas both are thought to reflect the same clinical target, the hypnotic component of anaesthesia. As a consequence, further studies are required to compare reliability of both indices as indicators of different levels of hypnosis.

Keywords

ANAESTHESIA, INHALATIONANAESTHESIA, INTRAVENOUSMONITORING, INTRAOPERATIVEELECTROENCEPHALOGRAPHY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 1 , January 2004 , pp. 6 - 12
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology 1998; 89: 980–1002.Google Scholar
Prichep LS, John ER, Gugino LD, Kox W, Chabot RJ. Quantitative EEG assessment of changes in the level of sedation/hypnosis during surgery under general anaesthesia. In: Jordan C, Vaughan DJA, Newton DEF, eds. Memory and Awareness in Anaesthesia.London, UK: Imperial College Press, 2000: 97–107.
John ER, Prichep LS, Kox W, et al. Invariant reversible QEEG effects of anesthetics. Conscious Cogn 2001; 10: 165–183.Google Scholar
Drover DR, Lemmens HJ, Pierce ET, et al. Patient State Index: titration of delivery and recovery from propofol, alfentanil, and nitrous oxide anesthesia. Anesthesiology 2002; 97: 82–89.Google Scholar
Brice DD, Hetherington RR, Utting JE. A simple study of awareness and dreaming during anaesthesia. Br J Anaesth 1970; 42: 535–542.Google Scholar
Bruhn J, Bouillon TW, Shafer SL. Bispectral index (BIS) and burst suppression: revealing a part of the BIS algorithm. J Clin Monit Comput 2000; 16: 593–596.Google Scholar
Lubke GH, Kerssens C, Phaf H, Sebel PS. Dependence of explicit and implicit memory on hypnotic state in trauma patients. Anesthesiology 1999; 90: 670–680.Google Scholar
Schnider TW, Luginbühl M, Petersen-Felix S, Mathis J. Unreasonably low bispectral index values in a volunteer with genetically determined low-voltage electroencephalographic signal. Anesthesiology 1998; 89: 1607–1608.Google Scholar
Detsch O, Schneider G, Kochs E, Hapfelmeier G, Werner C. Increasing isoflurane concentration may cause paradoxical increases in the EEG bispectral index in surgical patients. Br J Anaesth 2000; 84: 33–37.Google Scholar
Guignard B, Chauvin M. Bispectral index increases and decreases are not always signs of inadequate anesthesia. Anesthesiology 2000; 92: 903.Google Scholar
Puri GD. Paradoxical changes in bispectral index during nitrous oxide administration. Br J Anaesth 2001; 86: 141–142.Google Scholar
Schneider G, Wagner K, Reeker W, Hänel F, Werner C, Kochs E. Bispectral index (BIS) may not predict awareness reaction to intubation in surgical patients. J Neurosurg Anesthesiol 2002; 14: 7–11.Google Scholar
Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology 1997; 87: 808–815.Google Scholar