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• W2029012496 abstract "Bispectral index (BIS) monitors are increasingly popular as a measure of determining depth of anaesthesia. BIS monitoring is easy to perform and has been validated prospectively [1]. It is claimed to be associated with a lower consumption of anaesthetic agents, earlier awakening and faster recovery [2]. Awake craniotomy presents a unique challenge for the anaesthetist: to provide adequate sedation and analgesia but also an awake and cooperative patient for neurological testing. It has been suggested that the BIS might be useful in awake craniotomy. Hans et al. found that it correlated more closely with the conscious level of their patient than the calculated effect site concentration of the drugs used [3]. To determine whether the BIS monitor was useful during awake craniotomy, we carried out an observational study correlating BIS values with intra-operative events and the level of consciousness of the patient. Over a 6-month period, all patients undergoing awake craniotomy surgery for tumour resection were recruited. A standard anaesthetic technique was used: total intravenous anaesthesia with remifentanil and propofol. The infusion rate varied depending on haemodynamic variables and clinical response. BIS values were measured using an Aspect A-1000 XP monitor. Also recorded were heart rate, arterial pressure, propofol plasma concentration and remifentanil infusion rate. Nine patients were studied. All were found to require a similar infusion rate of the anaesthetic agents. All patients had been given anti-epileptic medication pre-operatively. All the patients moved with BIS values below 50 and experienced a delay of between 60 s and 4 min before the BIS rose above 80. Seven out of the nine patients reviewed were awake and obeying commands with BIS values of 50–70. There was little correlation between the haemodynamic response of the patients and the BIS score (Figure). Changes in BIS values during awake craniotomy surgery. There has been little research published into the use of BIS in patients with neurological disorders and in patients taking anti-epileptic medication. As both of these may affect the EEG, BIS values in these patients must be treated with caution. As the patient's conscious level increases, there is a clinically significant delay in increases in the BIS value, which limits its usefulness in predicting awakening." @default.
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• W2029012496 date "2002-12-01" @default.
• W2029012496 modified "2023-09-24" @default.
• W2029012496 title "Bispectral index monitoring during awake craniotomy surgery" @default.
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• W2029012496 doi "https://doi.org/10.1046/j.1365-2044.2002.t01-1-02963.x" @default.
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