Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries

Abstract Background The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in in...

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Main Authors: Ahmed Mohammed Fetouh Abdelrahman, Amr Arafa Elbadry, Amany Faheem Omara
Format: Article
Language:English
Published: BMC 2023-12-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-023-02372-x
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author Ahmed Mohammed Fetouh Abdelrahman
Amr Arafa Elbadry
Amany Faheem Omara
author_facet Ahmed Mohammed Fetouh Abdelrahman
Amr Arafa Elbadry
Amany Faheem Omara
author_sort Ahmed Mohammed Fetouh Abdelrahman
collection DOAJ
description Abstract Background The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in individual patients undergoing renal surgeries while lateral positions at various stages of anesthesia. Patients and methods 12 patients older than 18 years, ASA I-III patients scheduled for elective renal operations, two BIS were placed on each patient, one on each side of the post-auricular region and one across the forehead, and each sensor was connected to a different BIS monitor. We gathered three pieces of data at each of the six-time points: BIS score, signal quality index (SQI) score calculating the signal’s strength and electromyography (EMG) score: before the onset of anesthesia (awake) when the eyelash reflex is lost (LOC), after intubation (intubation), following the initial surgical incision, each 30 min throughout the procedure (maintenance), and at the moment the patient’s eyes open naturally after waking up from anesthesia (emergence). Results The overall BIS value at the frontal position was significantly higher than the post-auricular position (52.5 ± 22.2 and 52.1 ± 22.1, respectively, P = 0.010). On the other hand, the BIS value was comparable between the frontal and post-auricular positions at LOC, intubation, 60, 120, and 80 min and at emergence. A strong link between the two sensor positions, as indicated by the correlation coefficient (r = 0.607, P < 0.001), and the Bland-Altman analysis revealed a small mean difference (-1.8) and a low (9.0/- 12.5) limit of agreement, with just 4.3% of the readings falling outside of it during the anesthetic maintenance period. Conclusion Acceptable variation in BIS data was observed when obtained from the two different sensor positions for clinical usage. The post-auricular BIS sensor system may be a suitable substitute for an impractical frontal setup. Protocol Registration The study was registered in clinicaltrials.gov on 11/07/2022 (trial registration number: NCT05451823).
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spelling doaj.art-bc5520d5837240669219db94c4e4a2a92023-12-24T12:27:33ZengBMCBMC Anesthesiology1471-22532023-12-012311710.1186/s12871-023-02372-xComparison of post-auricular and frontal bispectral index values obtained during renal surgeriesAhmed Mohammed Fetouh Abdelrahman0Amr Arafa Elbadry1Amany Faheem Omara2Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta UniversityAnesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta UniversityAnesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta UniversityAbstract Background The bispectral index (BIS) monitor is one of the EEG-derived monitoring techniques and well-established devices used to measure the depth of anesthesia. This study aimed to assess the agreement of BIS values based on the positions of either post-auricular or frontal sensors in individual patients undergoing renal surgeries while lateral positions at various stages of anesthesia. Patients and methods 12 patients older than 18 years, ASA I-III patients scheduled for elective renal operations, two BIS were placed on each patient, one on each side of the post-auricular region and one across the forehead, and each sensor was connected to a different BIS monitor. We gathered three pieces of data at each of the six-time points: BIS score, signal quality index (SQI) score calculating the signal’s strength and electromyography (EMG) score: before the onset of anesthesia (awake) when the eyelash reflex is lost (LOC), after intubation (intubation), following the initial surgical incision, each 30 min throughout the procedure (maintenance), and at the moment the patient’s eyes open naturally after waking up from anesthesia (emergence). Results The overall BIS value at the frontal position was significantly higher than the post-auricular position (52.5 ± 22.2 and 52.1 ± 22.1, respectively, P = 0.010). On the other hand, the BIS value was comparable between the frontal and post-auricular positions at LOC, intubation, 60, 120, and 80 min and at emergence. A strong link between the two sensor positions, as indicated by the correlation coefficient (r = 0.607, P < 0.001), and the Bland-Altman analysis revealed a small mean difference (-1.8) and a low (9.0/- 12.5) limit of agreement, with just 4.3% of the readings falling outside of it during the anesthetic maintenance period. Conclusion Acceptable variation in BIS data was observed when obtained from the two different sensor positions for clinical usage. The post-auricular BIS sensor system may be a suitable substitute for an impractical frontal setup. Protocol Registration The study was registered in clinicaltrials.gov on 11/07/2022 (trial registration number: NCT05451823).https://doi.org/10.1186/s12871-023-02372-xBispectral indexDepth of anesthesiaFrontalPost-auricular.
spellingShingle Ahmed Mohammed Fetouh Abdelrahman
Amr Arafa Elbadry
Amany Faheem Omara
Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
BMC Anesthesiology
Bispectral index
Depth of anesthesia
Frontal
Post-auricular.
title Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
title_full Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
title_fullStr Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
title_full_unstemmed Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
title_short Comparison of post-auricular and frontal bispectral index values obtained during renal surgeries
title_sort comparison of post auricular and frontal bispectral index values obtained during renal surgeries
topic Bispectral index
Depth of anesthesia
Frontal
Post-auricular.
url https://doi.org/10.1186/s12871-023-02372-x
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AT amanyfaheemomara comparisonofpostauricularandfrontalbispectralindexvaluesobtainedduringrenalsurgeries