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Framed Question: Bispectral Index Evidence
ID: 204092     
ISSN #: 1365-2044 (Electronic)
Publication Type: Clinical Trial
Title: Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children.
Authors: Lamas A
Lopez-Herce J
Sancho L
Mencia S
Carrillo A
Jose Santiago M
Martinez V
Source: Anaesthesia. 2008 Dec;63(12):1296-301.
Acronym:
MeSH: Acoustic Stimulation/methods
Adolescent
*Awareness
Blood Pressure
Child
Child, Preschool
*Conscious Sedation
Critical Care/*methods
Critical Illness/*therapy
Electroencephalography
*Evoked Potentials, Auditory
Female
Heart Rate
Humans
Infant
Infant, Newborn
Male
Neuromuscular Blocking Agents/pharmacology
Physical Stimulation/methods
Prospective Studies
Reaction Time
Respiration, Artificial
Abstract: SUMMARY: We performed simultaneous recordings of Bispectral Index (BIS) and middle latency auditory evoked potentials. We also recorded two clinical scales, the Modified Ramsay scale and the COMFORT scale. Heart rate and blood pressure were measured once a day, for a maximum of 5 days, in 81 critically ill children. Changes with tactile, auditory, and painful stimuli were analysed. All the stimuli significantly increased the BIS value, the painful stimulus having the greatest effect. The painful stimulus was the only one that altered the middle latency auditory evoked potentials. Although the responses of the clinical scales to stimuli were statistically significant, they were of little clinical relevance. None of the stimuli used significantly altered the heart rate or blood pressure. We conclude that tactile, auditory and painful stimuli produced changes of little relevance in the clinical scales, BIS or middle latency auditory evoked potentials. We found the BIS was the most sensitive method and the painful stimulus had the greatest effect.
Country: England
Language: eng
Institution: Pediatric Intensive Care Unit, Gregorio Marañón University General Hospital, Madrid, Spain.
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