title: Does patient position influence the reading of the bispectral index monitor?
abstract: BACKGROUND
  Bispectral index (BIS) was developed to monitor patients' level of consciousness under general anesthesia. Several factors have been found to alter BIS readings without affecting the depth of anesthesia. We conducted a study to assess the impact of changing patients' position on BIS readings.
  
  
  METHODS
  General anesthesia was administered to 40 patients undergoing minor surgeries. Patients were kept in neutral position (supine) for 15 min and BIS readings, mean arterial blood pressure, heart rate, end-tidal carbon dioxide, and end-tidal isoflurane were recorded. Patients were then shifted to head-down position (30 degrees), neutral position, and lastly head-up position (30 degrees) each of 15-min duration and the data were recorded.
  
  
  RESULTS
  There was a significant increase in BIS values in head-down position (median 47 vs 40) compared with neutral position, whereas head-up position significantly decreased BIS (39 vs 41) compared with neutral position (P < 0.05).
  
  
  CONCLUSIONS
  Changing a patient's position significantly affects the BIS values, which might affect the interpretation of anesthetic depth.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, King Abdulaziz University Hospital, PO Box 2907, Jeddah 21461, Saudi Arabia. amkaki@yahoo.com
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Kaki
authors.forename: Waleed A
authors.initials: WA
authors.lastname: Almarakbi
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D001784:Blood Gas Analysis; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015924:Blood Pressure Monitors; D003243:Consciousness; D056805:Consciousness Monitors; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D004569:Electroencephalography / Q000295:instrumentation; D018475:Head-Down Tilt; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D011187:Posture; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted; D016683:Supine Position; D013997:Time Factors; D055815:Young Adult