BIS/PNS reduced

Question 1

BIS minitor

What is it

Goals and numerical values

Benifits

Answer 1

Uses EEG analysis as and index of awareness

1. Awake vs Deeply anestheitzed EEG
   
   • Awake = LOW amplitude, HIGH frquency
   • Deeply anesthetized = High Amlitude, LOW frequency

GOAL = maintinenc between 40 and 60 (<40 used for cardiac sugery)

​The lower the value the deeper the sedation (continuum from 100→ 0)

• 100 = awake
  
  • awake or resting state
  • concious sedation
  • response to vigerous stimulation durring surgery
  • Emergence from general anesthesia
• 70 = Light hypnotic effects
  
  • light anesthesia
  • < 70 = little probability of recall
• 60 = Moderate hypntic effects
  
  • can be used for surgical procedures
  • < 60 = unconciousness
• 40 = deep hypnotic effects
  
  • can be used for surgical procedures
  • High dose opioid anesthesia
  • Barbiturate coma
  • Profound Hypothermia
• 0 = EEG supression

Benifits of BIS monitoring

• Lower risk of awareness
• More rational selection of CV interventions (in deciding if something is d/t pain or something CV related)
• Better management of response to surgical stimulation
• Faster wake-up and recovery
• More cost-effective use of drugs

Question 2

If placed correctly, electrode 4 will be placed directly over the _____ muscle

Answer 2

frontalis

This makes the BIS more sensitive to muscle movement.

Question 3

How do you place the BIS monitor

Answer 3

1. Cleanse the forehead with alcohol
2. place electrodes at a diagonal angle with electrode #4 on the frontalis muscle
3. press on the outer edge to attach electrodes
4. Then press on the center of each electrode