Spike‐monitoring of anaesthesia for corpus callosotomy using bilateral bispectral index

Abstract

SummaryDuring corpus callosotomy for intractable epilepsy, the electrocorticogram is commonly recorded from electrodes placed on the brain surface to monitor of epileptic activity and assess the synchronisation of epileptic signals between the left and the right hemispheres. We evaluated the usefulness of bilateral bispectral index monitoring using two monitors and two sensors placed above the frontal region. Spikes were readily detected on the electroencephalogram on the bispectral index monitor, and the frequency of their occurrence increased or decreased in response to adjustment of the sevoflurane concentration. The disappearance of synchronisation between the left and the right hemispheres was observed with use of the bispectral index -in concordance with the electrocorticogram. Thus, 'spike-monitoring anaesthesia' using bilateral bispectral index was useful in assessing both the effect of anaesthetics on the electroencephalogram signals and the surgical therapeutic effect.

Analysis of electroencephalogram-derived indexes for anesthetic depth monitoring in pediatric patients with intellectual disability undergoing dental surgery

“…This may be related to EEG alterations that are reflected in the anesthetic depth indexes, such as spike-wave discharges observed in this study. In a case report of BIS and bilateral raw EEG monitoring in a patient with this syndrome, the EEG spike activity increased with the increase in sevoflurane concentration [ 13 ]. This could explain why, in our study, the patient with this syndrome had such poor performance of BIS and SEF95: due to a paradoxical increase of the index values, with increased spike activity during deeper anesthesia.…”

Processed EEG from depth of anaesthesia monitors and seizures: A scoping review

“…7 case reports were identified documenting the pEEG parameters from depth of anaesthesia monitoring during clinical seizures or epileptiform appearances on EEG [29,[31][32][33][34][35][36]. These were during anaesthetic induction or the operative phase.…”

El papel del anestesiólogo en cirugía de epilepsia

“…Imagen en color en: www.medigraphic.com/analesmedicos www.medigraphic.org.mx conocimiento más profundo de las ondas electroencefalográficas, ya que los números de los distintos tipos de neuromonitoreo en pacientes bajo anestesia superficial pierden sensibilidad y es difícil correlacionarlos con la clínica. 27 Hay estudios en los que se usa índice biespectral bilateral (BIS) en cirugía funcional que no demostraron ventaja en las callosotomías; 48 también, se han realizado estudios comparativos entre BIS y entropía, los cuales no han demostrado superioridad uno sobre otro. Generalmente, es tarea para el neurofisiólogo comunicar las necesidades de la profundidad anestésica que busquen optimizar los resultados de la cirugía.…”