Galante Dario, Fortarezza Donatella, Caggiano Maria, de Francisci Giovanni, Pedrotti Dino, Caruselli Marco
Departamento de Anestesia e Tratamento Intensivo, Hospitais Reunidos, Foggia, Itália.
Departamento de Anestesia e Tratamento Intensivo, Hospitais Reunidos, Foggia, Itália.
Rev Bras Anestesiol. 2015 Sep-Oct;65(5):379-83. doi: 10.1016/j.bjan.2014.07.009. Epub 2015 Mar 6.
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.
A 13-year-old child weighing 32kg, 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.
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.
脑电双频指数（BIS）是一种通过脑电图（EEG）得出的参数，可直接测量镇静剂和麻醉剂对大脑的影响，并为麻醉深度提供指导。目前文献中缺乏关于先天性脑部疾病小儿患者在全身麻醉期间进行BIS监测的研究。
一名13岁、体重32kg的儿童，患有叶状全前脑畸形，在手术中通过脑电双频指数（BIS）监测麻醉深度时出现异常反应。对不同观察时间点BIS值趋势的详细分析表明，BIS值突然下降且出现重复值，这可能与七氟醚引起的重复性癫痫样电活动有关。
BIS是评估麻醉深度和分析麻醉药脑电图变化的非常有用的监测工具。对于患有中枢神经系统先天性疾病的患者应特别注意，因为在这类患者中BIS可能会给出异常反应，无法准确反映麻醉深度。
