Work

Frequency and duration of BIS values outside 40–60 during blinded BIS recording in paediatric anaesthesia: a prospective observational study

Year: 2026

Type: article

Abstract: This prospective observational study included 104 paediatric patients aged 1–19 years undergoing elective surgery under sevoflurane-based general anaesthesia and combined anaesthesia (general anaesthesia combined with a regional anaesthetic technique) between January 2022 and March 2024. BIS was recorded continuously while anaesthesiologists were blinded to the readings. Episodes of BIS < 40 or > 60 lasting ≥ 30 s were analysed. Postoperative outcomes included emergence delirium (ED) (PAED score), postoperative nausea and vomiting (PONV), and other complications in patients admitted to the PACU. Overall, 85.6% of patients experienced at least one episode outside the recommended BIS range. The median time spent outside BIS 40–60 was 22 min (35.1% of the duration of surgery). Episodes of BIS < 40 were observed in 61.5% of patients, and BIS > 60 occurred in 51.9% of patients. Blinded BIS monitoring revealed frequent and prolonged deviations from the conventionally recommended anaesthetic depth range in paediatric patients, even when anaesthesia was managed according to conventional physiological and clinical parameters. However, the clinical significance of these findings and their relationship to postoperative outcomes remain uncertain.

Source: Scientific Reports

DOI: 10.1038/s41598-026-75763-y