Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study
Background Bi-spectral index (BIS) has been traditionally used to monitor the depth of anesthesia, with the forehead being the usual site for electrode placement. When the manufacturer-recommended site is itself an operative field or the placement interferes with the surgery, the search for an alter...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-09-01
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| Series: | Journal of Neuroanaesthesiology and Critical Care |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1756430 |
| _version_ | 1797945179401879552 |
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| author | Jitendra K. Dubey Nitesh Goel Rajiv Chawla Manish Gupta Manoj Bhardwaj |
| author_facet | Jitendra K. Dubey Nitesh Goel Rajiv Chawla Manish Gupta Manoj Bhardwaj |
| author_sort | Jitendra K. Dubey |
| collection | DOAJ |
| description | Background Bi-spectral index (BIS) has been traditionally used to monitor the depth of anesthesia, with the forehead being the usual site for electrode placement. When the manufacturer-recommended site is itself an operative field or the placement interferes with the surgery, the search for an alternative position of electrode placement is warranted. In our endeavor to do so, we conducted this study to compare BIS scores derived from frontal and supralabial electrode placement.
Methods A cross-sectional study was conducted on a group of 50 patients using two BIS Quatro sensors attached to the frontal and supralabial regions of each patient and connected to two different sets of monitors. BIS values, electromyography (EMG) values, and signal quality index (SQI) were noted from both sites every 15 min during the maintenance phase of anesthesia. Collected data were analyzed using the Bland–Altman analysis.
Results Data analysis of BIS values showed negative bias at most time points with a minimum negative bias of 0.2 with a limit of agreement of −3.67/3.27 and a maximum negative bias of 1.14 with a limit of agreement of −7.61/5.33. The overall 95% limit of agreement for pooled BIS data ranged from −6.63 to 6.1.
Conclusion BIS sensor placement at the supralabial site can be used as an alternative to the frontal placement in scenarios where the frontal position is the surgical site or is inaccessible during the maintenance of general anesthesia as in neurosurgery with particular emphasis on skin preparation and proper positioning of BIS electrodes to improve the signal quality. |
| first_indexed | 2024-04-10T20:51:04Z |
| format | Article |
| id | doaj.art-32e13f9a899047dba8fca5ccbb90c4c6 |
| institution | Directory Open Access Journal |
| issn | 2348-0548 2348-926X |
| language | English |
| last_indexed | 2024-04-10T20:51:04Z |
| publishDate | 2022-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Neuroanaesthesiology and Critical Care |
| spelling | doaj.art-32e13f9a899047dba8fca5ccbb90c4c62023-01-23T09:33:23ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X2022-09-01090314915410.1055/s-0042-1756430Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional StudyJitendra K. Dubey0Nitesh Goel1Rajiv Chawla2Manish Gupta3Manoj Bhardwaj4Department of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDepartment of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDepartment of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDepartment of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDepartment of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaBackground Bi-spectral index (BIS) has been traditionally used to monitor the depth of anesthesia, with the forehead being the usual site for electrode placement. When the manufacturer-recommended site is itself an operative field or the placement interferes with the surgery, the search for an alternative position of electrode placement is warranted. In our endeavor to do so, we conducted this study to compare BIS scores derived from frontal and supralabial electrode placement. Methods A cross-sectional study was conducted on a group of 50 patients using two BIS Quatro sensors attached to the frontal and supralabial regions of each patient and connected to two different sets of monitors. BIS values, electromyography (EMG) values, and signal quality index (SQI) were noted from both sites every 15 min during the maintenance phase of anesthesia. Collected data were analyzed using the Bland–Altman analysis. Results Data analysis of BIS values showed negative bias at most time points with a minimum negative bias of 0.2 with a limit of agreement of −3.67/3.27 and a maximum negative bias of 1.14 with a limit of agreement of −7.61/5.33. The overall 95% limit of agreement for pooled BIS data ranged from −6.63 to 6.1. Conclusion BIS sensor placement at the supralabial site can be used as an alternative to the frontal placement in scenarios where the frontal position is the surgical site or is inaccessible during the maintenance of general anesthesia as in neurosurgery with particular emphasis on skin preparation and proper positioning of BIS electrodes to improve the signal quality.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1756430supralabialbispectral indexintraoperative awareness |
| spellingShingle | Jitendra K. Dubey Nitesh Goel Rajiv Chawla Manish Gupta Manoj Bhardwaj Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study Journal of Neuroanaesthesiology and Critical Care supralabial bispectral index intraoperative awareness |
| title | Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study |
| title_full | Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study |
| title_fullStr | Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study |
| title_full_unstemmed | Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study |
| title_short | Supralabial Site: An Alternative Site for Bispectral Index Monitoring: A Cross-sectional Study |
| title_sort | supralabial site an alternative site for bispectral index monitoring a cross sectional study |
| topic | supralabial bispectral index intraoperative awareness |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1756430 |
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