Correlation of bispectral index (BIS) monitoring and end-tidal sevoflurane concentration in a patient with lobar holoprosencephaly

ABSTRACTOBJECTIVE: The bispectral index (BIS) is a parameter derived by electroencephalography (EEG) which provides a direct measurement of the effects of sedatives and anesthetics on the brain and offers guidance on the adequacy of anesthesia. The literature lacks studies on BIS monitoring in pediatric patients with congenital brain disease undergoing general anesthesia.CLINICAL FEATURES: A 13-year-old child weighing 32 kg, suffering from lobar holoprosencephaly, underwent surgery in which the bispectral index (BIS) monitoring the depth of anesthesia showed an abnormal response. Detailed analysis of the trends of BIS values in the different observation times demonstrated sudden falls and repetitive values of BIS likely related to repetitive epileptiform electrical activity caused by sevoflurane.CONCLUSION: The BIS is a very useful monitoring tool for assessing the degree of depth of anesthesia and to analyze the electroencephalographic variations of anesthetics. Particular attention should be given to patients with congenital disorders of the central nervous system in which the BIS may give abnormal responses that do not reflect an accurate assessment of the depth of anesthesia.

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Bibliographic Details
Main Authors: Galante,Dario, Fortarezza,Donatella, Caggiano,Maria, Francisci,Giovanni de, Pedrotti,Dino, Caruselli,Marco
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Anestesiologia 2015
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942015000500379
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