title: Bispectral index as an indicator of cerebral hypoperfusion during off-pump coronary artery bypass grafting.
abstract: Bradycardia and hypotension are common during off-pump coronary artery bypass grafting (OPCAB). We present a case of possible reversible global cerebral hypoperfusion during distal grafting of the left circumflex coronary artery. The bispectral index (BIS) suddenly decreased from values of 45-50 to 0 during distal grafting. Neurologic evaluation after immediate tracheal extubation in the operating room was normal and the 58 yr old patient did not suffer any neurologic sequelae. Postoperative recovery was uneventful and the patient was discharged 5 days after surgery. Cerebral hypoperfusion is a possible complication during OPCAB. BIS monitoring in OPCAB could be an indicator of cerebral hypoperfusion.
authors.affiliation: From the Perioperative Cardiac Research Group (PECARG), Departments of Anesthesiology and *Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Hôtel-Dieu, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Hemmerling
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Olivier
authors.forename: Fadi
authors.initials: F
authors.lastname: Basile
authors.forename: Nien
authors.initials: N
authors.lastname: Le
authors.forename: Ignatio
authors.initials: I
authors.lastname: Prieto
mesh_terms: D000787:Angina Pectoris / Q000601:surgery; D001794:Blood Pressure; D002560:Cerebrovascular Circulation / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D004569:Electroencephalography / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative