The Feasibility of Bispectral Index Monitoring

In: Anesthesia

16 Sep 2009

The Feasibility of Bispectral Index Monitoring

The benefits of bispectral index monitoring include improvement in regulation of anesthesia and reduction in anesthetic dose. We previously described the usefulness of bispectral index monitoring in oral surgery with the patients under general anesthesia. Our previous studies showed that the percentage of good electroencephalograms (EEGs) in oral surgery with patients under general anesthesia with sevoflurane or total intravenous anesthesia was 96.8% ± 2.1% (n = 8) for sevoflurane and 94.6% ± 2.3% (n = 7) for total intravenous anesthesia. However, since the sensor is attached to the forehead, which may be close to the site of operation, and since no neuromuscular blocking drugs are used, monitoring may be excessively interrupted by artifacts such as electromyographic (EMG) input under intravenous sedation during dental treatment. On the other hand, since the bispectral index is directly proportional to the intravascular concentration of pro­pofol under light sedation, bispectral index monitoring adequately reflects the depth of sedation. We investigated the feasibility of bispectral index monitoring for patients under intravenous sedation during dental treatment by comparing the signal quality index (SQI) EEG epoch containing no contaminating artifacts in the last 60 seconds of EMG input, impedance, and good EEG (EMG < 50 dB, SQI > 25%, and impedance < 10 Ш) with those obtained with the patient under general anesthesia in oral surgery.

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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.