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PEDIATRIC ANESTHESIA

Validation of the Bispectral Index Monitor During Conscious and Deep Sedation in Children

Department of Anesthesiology, The Children’s Hospital and the University of Colorado School of Medicine, Denver, Colorado

Address correspondence and reprint requests to Robert H. Friesen, MD, Department of Anesthesiology, The Children’s Hospital, 1056 E. 19th Ave., Denver, CO 80218. Address e-mail to friesen.robert{at}tchden.org

In this study, we tested the validity of the bispectral index (BIS) monitor during conscious and deep sedation of children by comparing it with the University of Michigan Sedation Scale (UMSS), a validated observational pediatric sedation scale. Eighty-six children <12 yr of age were enrolled in this observational study. The subjects underwent conscious or deep sedation administered by non-anesthesiologists for diagnostic or therapeutic procedures in four departments in a children’s hospital. Sedation medications varied among departments and were not controlled by the study protocol. An independent observer derived a UMSS score at 10-min intervals for 1 h during sedation; personnel administering sedation medications and performing the procedures were blinded to the BIS and UMSS scores. Significant correlation between BIS scores and UMSS scores was found (r = -0.704, P < 0.0001), including in subjects <6 mo of age (n = 6) (r = -0.761, P < 0.001). Poor correlation was found when ketamine or an oral combination of chloral hydrate, hydroxyzine, and meperidine were used for sedation. We conclude that BIS correlates well with UMSS scores and may be a valid measure of conscious and deep sedation in children.

IMPLICATIONS: We compared bispectral index scores with a validated observational scale of conscious and deep sedation in children and found significant correlation. We conclude that the bispectral index may be a valid measurement of depth of sedation in children.

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