Decrease in Bispectral Index Preceding Intraoperative Hemodynamic Crisis: Evidence of Acute Alteration of Propofol Pharmacokinetics
Year: 2002
Type: article
Study design: Case Report
Abstract: THE bispectral index (BIS®, Aspect Medical Systems Inc., Newton, MA) is a processed electroencephalographic variable which correlates with depth of hypnosis in adult patients during general anesthesia, 1,2 It has also been used clinically to guide anesthetic drug administration, 3 and to quantify the pharmacodynamic action of anesthetic drugs in the laboratory setting. 4 HIS has previously been shown to decrease following hypovolemic cardiac arrest, lagging behind the decrease in blood pressure by approximately 2 min. 5 We report a case of unrecognized venous hemorrhage with a fatal outcome during total intravenous anesthesia (TIVA) for elective abdominal aortic aneurysm repair, where the BIS score began to decrease well before other monitored variables suggested clinical deterioration, and we propose that BIS-derived data may provide early insights into altered drug pharmacokinetics due to hemorrhage.
Source: Anesthesiology
Authors: David M. Honan, Patrick J. Breen, John F. Boylan, Neil J. McDonald, Talmage D. Egan
Institutions: University of Utah, St. Vincent's University Hospital
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2037844809