Contact dermatitis associated with the Bispectral index™ sensor: a case report

Abstract

Background Contact dermatitis caused by electroencephalography electrodes is rare and insufficiently studied. We described a case of contact dermatitis caused by Bispectral Index (BIS) monitor electrodes. Case presentation A 38-year-old woman underwent tooth extraction under general anesthesia with BIS monitoring. She noticed erythema on her forehead 3 days after surgery, which peaked on the fifth postoperative day. Slight pigmentation was observed at 42 days after surgery. We performed patch testing and confirmed positive reactions to the sensor and some allergens. Conclusions Many reports have attributed contact dermatitis to an allergen present in electrocardiogram electrodes. It is important to recognize that complications similar to those caused by electrocardiogram electrodes can occur with this sensor.

Soft and Conductive Polyethylene Glycol Hydrogel Electrodes for Electrocardiogram Monitoring

“…First, metal electrodes with excellent electrical conductivity have been conventionally adopted for neural recording but are less effective in surface ECG applications because of their potential for allergic reactions to metals, unstable contact causing motion artifacts, and the requirement for sharp tissue penetration [5][6][7]. Second, according to clinical reports regarding the patients' discomfort after applying the Ag/AgCl-gel electrodes onto their skin, the silver-based electrodes caused skin irritations, such as rashes and itching, during electrophysiological monitoring [8][9][10][11][12][13]. Third, these conventional electrodes lack flexibility, Gels 2023, 9, 957 2 of 12 making it challenging to maintain extremely conformal contacts with the soft and curved surface of the skin, which impedes the accurate measurement of biosignals [14,15].…”

“…onto their skin, the silver-based electrodes caused skin irritations, such as rashes and itching, during electrophysiological monitoring [8][9][10][11][12][13]. Third, these conventional electrodes lack flexibility, making it challenging to maintain extremely conformal contacts with the soft and curved surface of the skin, which impedes the accurate measurement of biosignals [14,15].…”