BIS guide for clinicians

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The BIS Index The BIS Index: A Continuum The BIS Index is a number between 0 and 100 scaled to correlate with important clinical endpoints and EEG states during administration of anesthetic agents (Figure 2). BIS values near 100 represent an “awake” clinical state while 0 denotes the maximal EEG effect possible (i.e., an isoelectric EEG). Figure 2: The BIS Index is scaled to correlate with important clinical endpoints during administration of anesthetic agent. 7
It should be noted that the BIS index range represents a continuum that correlates to the clinical state and expected responses (Figure 3). 100 80 Awake • Responds to normal voice Light/Moderate Sedation • May respond to loud commands or mild prodding/shaking BIS Index Range 60 40 20 General Anesthesia • Low probability of explicit recall • Unresponsive to verbal stimulus Deep Hypnotic State • Burst Suppression 0 Flat Line EEG 8 This chart reflects a general association between clinical state and BIS values. Ranges are based on results from a multi-center study of the BIS involving the administration of specific anesthetic agents. 8 BIS values and ranges assume that the EEG is free of artifacts that can affect its performance. Titration of anesthetics to BIS ranges should be dependent upon the individual goals established for each patient. These goals and associated BIS ranges may vary over time and in the context of patient status and treatment plan. Figure 3: BIS Index Range: A Continuum of Clinical State and EEG Changes
Page 2 and 3: Monitoring Consciousness Using the
Page 4: Table of Contents Executive Overvie
Page 7 and 8: With progressive drug-induced sedat
Page 9 and 10: 4 Important Information About Using
Page 11: the correlation between all the fre
Page 15 and 16: halothane has been found to have hi
Page 17 and 18: Table 1: BIS monitoring during a ge
Page 19 and 20: Integrating BIS Information During
Page 21 and 22: Table 2: Anesthesia management stra
Page 23 and 24: Special Issues Impacting BIS Monito
Page 25 and 26: Table 3: Reported factors influenci
Page 27 and 28: Table 4: BIS increase/high value as
Page 29 and 30: Clinical Impact of BIS Monitoring T
Page 31 and 32: Table 6: Potential risk factors for
Page 33 and 34: ASA Practice Advisory The “Practi
Page 35 and 36: AVOIDING AWARENESS ALGORITHM Preope
Page 37 and 38: BIS Monitoring and Awareness: Evide
Page 39 and 40: Intraoperative Awareness & Anesthes
Page 41 and 42: The ability of brain function monit
Page 43 and 44: References 1. Sigl J, et al. J Clin
Page 45 and 46: 45. Mychaskiw G, et al. Anesth Anal

BIS guide for clinicians

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