This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Choudhry, D. K. Articles by Brenn, B. R. Search for Related Content PubMed PubMed Citation Articles by Choudhry, D. K. Articles by Brenn, B. R. Related Collections Monitoring (Non-cardiac) Pediatrics

---

PEDIATRIC ANESTHESIA

Bispectral Index Monitoring: A Comparison Between Normal Children and Children with Quadriplegic Cerebral Palsy

Department of Anesthesiology and Critical Care, Alfred I. duPont Hospital for Children, Wilmington, Delaware

Address correspondence and reprint requests to Dinesh K. Choudhry, MD, FRCA, Department of Anesthesiology and Critical Care, Alfred I. duPont Hospital for Children, PO Box 269, Wilmington, DE 19899. Address e-mail to dchoudhr{at}nemours.org

We performed this study to compare the correlation of bispectral index (BIS) values with different sevoflurane concentrations between normal children and those with quadriplegic cerebral palsy with mental retardation (CPMR). Twenty children with CPMR (Group I) and 21 normal children (Group II) between 2 and 14 yr of age were studied. Anesthesia was induced and maintained with sevoflurane and 66% N₂O/O₂. Bispectral values were recorded on an Aspect Medical Systems (Natick, MA) monitor, and sevoflurane concentrations were measured with an Ohmeda (Hanover, MA) inhaled anesthetic monitor. The BIS values were recorded after midazolam premedication; after the induction of anesthesia; at end-tidal sevoflurane concentrations of 1%, 3%, and again at 1%; and after emergence from the anesthetic. Both groups were similar in age and sex distribution, but children in Group I weighed less than those in Group II (P < 0.05). The BIS values were significantly lower in Group I compared with Group II after sedation, at 1% sevoflurane concentrations, and after emergence. No difference was observed between the two groups at anesthesia induction (8%) and at 3% sevoflurane concentration. We conclude that, in children with CPMR, BIS values exhibit a pattern of change similar to that observed in normal children. However, absolute BIS values obtained in such children are lower than those in normal children while awake and at different sevoflurane concentrations.

IMPLICATIONS: We compared bispectral (BIS) values with different sevoflurane concentrations between normal children and children with cerebral palsy. We observed that, in children with cerebral palsy, BIS values exhibited a similar pattern of change as is observed in normal children. However, absolute BIS values obtained in such children are lower than those in normal children while awake and at different sevoflurane concentrations.

This article has been cited by other articles:

				A. J. Valkenburg, T. G. de Leeuw, D. Tibboel, and F. Weber Lower Bispectral Index Values in Children Who Are Intellectually Disabled Anesth. Analg., November 1, 2009; 109(5): 1428 - 1433. [Abstract] [Full Text] [PDF]

				C. Bennett, L. J. Voss, J. P. M. Barnard, and J. W. Sleigh Practical Use of the Raw Electroencephalogram Waveform During General Anesthesia: The Art and Science Anesth. Analg., August 1, 2009; 109(2): 539 - 550. [Abstract] [Full Text] [PDF]

				A. A. Dahaba Different Conditions That Could Result in the Bispectral Index Indicating an Incorrect Hypnotic State Anesth. Analg., September 1, 2005; 101(3): 765 - 773. [Abstract] [Full Text] [PDF]

				P. S. Myles and S. Cairo Artifact in the Bispectral Index in a Patient with Severe Ischemic Brain Injury Anesth. Analg., March 1, 2004; 98(3): 706 - 707. [Abstract] [Full Text] [PDF]