Bispectral Analysis During Pediatric Procedural Sedation
- 1 January 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pediatric Emergency Care
- Vol. 21 (1), 6-11
- https://doi.org/10.1097/01.pec.0000150981.88733.d8
Abstract
Bispectral analysis (BIS) is a technology using EEG information from a forehead electrode to calculate an index (0-100; 0 = coma, 90-100 = awake). Our objective was to determine the degree of agreement between sedation scales and BIS values in pediatric patients undergoing sedation. Patients ages 2 to 17 years, undergoing procedural sedation, were enrolled. Sedation was performed in the customary manner with the addition of BIS monitoring and assessment of a clinical sedation scale: the Observer's Assessment of Alertness/Sedation (OAA/S), every 5 minutes during the sedation procedure. Clinical scales were performed by an investigator blinded to the BIS index. The association between a clinical scale and BIS scores was analyzed using longitudinal regression analysis. We enrolled 47 subjects; 55% were sedated with ketamine and midazolam and the remaining 45% received methohexital, propofol or midazolam and a narcotic. The results of the regression analysis demonstrated a highly significant association between the OAA/S score and BIS value (beta = 5.0, 95% CI 4.3 to 5.7, P < 0.0001). Patients were divided into 2 groups, those sedated with ketamine and those sedated with nonketamine medications. The association between OAA/S score and BIS value was not statistically significant for the ketamine population (beta = 0.809, 95% CI -0.1 to 1.7, P = 0.09), but remained significant for the nonketamine subjects (beta = 8.6, 95% CI 7.7 to 9.4, P < 0.0001). The OAA/S sedation scale predicts the BIS value for pediatric patients undergoing procedural sedation when sedated with certain medications, excluding ketamine.Keywords
This publication has 15 references indexed in Scilit:
- A study of the bispectral index monitor during procedural sedation and analgesia in the emergency departmentAnnals of Emergency Medicine, 2003
- The Differences in the Bispectral Index Between infants and Children During Emergence from Anesthesia After Circumcision SurgeryAnesthesia & Analgesia, 2001
- Bispectral index monitoring of sedation during endoscopyGastrointestinal Endoscopy, 2000
- Randomized placebo-controlled trial to assess the effect of remifentanil and propofol on bispectral index and sedationBritish Journal of Anaesthesia, 2000
- EEG bispectral index monitoring in sevoflurane or propofol anaesthesia: analysis of direct costs and immediate recoveryActa Anaesthesiologica Scandinavica, 1999
- Relationship between calculated blood concentration of propofol and electrophysiological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential indexBritish Journal of Anaesthesia, 1997
- Electroencephalographic Bispectral Index Correlates with Intraoperative Recall and Depth of Propofol-Induced SedationAnesthesia & Analgesia, 1997
- An introduction to bispectral analysis for the electroencephalogramJournal of Clinical Monitoring and Computing, 1994
- Validity and Reliability of the Observer??sJournal of Clinical Psychopharmacology, 1990
- Electroencephalographic Study of Children During Ketamine AnesthesiaActa Anaesthesiologica Scandinavica, 1976