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Anesth Analg 2006;103:1049-1050
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000239064.99796.f2

LETTER TO THE EDITOR

Editor-in-Chief Steven L. Shafer

BIS and the Electromyogram

Ngai Liu, MD, Thierry Chazot, MD, and Marc Fischler, MD

Department of Anesthesiology; Hôpital Foch; m.fischler{at}hopital-foch.org

In Response:

Drs. Renna and Gillbe are right (1) when they stated that they reported electromyographic (EMG) effects on bispectral index (BIS) during large-dose opioid induction (2). When compared with our methodology (3), theirs was more sophisticated: one group of 13 patients received 50 mcg/kg of fentanyl and a second group of 13 patients received 10 mcg/kg of fentanyl plus 0.2 mcg/kg of etomidate. They used a backward stepwise multiple regression analysis including five items to evaluate the relationship of BIS-EMG. Our simpler model mimics everyday practice: propofol titrated to loss of consciousness, followed by a bolus of atracurium (or placebo in the control group) 2 min after loss of consciousness. We demonstrated the BIS-myorelaxation relationship using simple statistical analysis. Nevertheless, our conclusions are in agreement with theirs.

REFERENCES

  1. Renna M, Gillbe C. BIS and the electomyogram. Anesth Analg 2006;103:1049.[Free Full Text]
  2. Renna M, Wigmore T, Mofeez A, Gillbe C. Biasing effect of the electromyogram on BIS: a controlled study during high-dose fentanyl induction. J Clin Monit Comput 2002:17:377–81.[Medline]
  3. Liu N, Chazot T, Huybrechts I, et al. The influence of a muscle relaxant bolus on bispectral and Datex-Ohmeda entropy values during propofol-remifentanil induced loss of consciousness. Anesth Analg 2005;101:1713–18.[Abstract/Free Full Text]




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press