title: Clinically relevant asymmetry of bispectral index during recovery from anaesthesia for ear-nose-throat surgery in adults and children.
abstract: This study investigates the incidence of clinically relevant asymmetry in bispectral index readings from different sides of the skull (using two monitors) during ear-nose-throat surgery in 42 adults and 46 children. A unilateral increase or decrease > 10% from baseline was defined as an 'asymmetry'. Asymmetry followed by movement after stimulation was defined as a 'clinically relevant asymmetry'. Asymmetry occurred in 39 out of 42 adults (93%) and in 20 out of 46 children (44%) during surgery and in 24 out of 42 adults (57%) and in 17 out of 46 children (37%) during recovery. Clinically relevant asymmetry was observed in 5 out of 42 adults (12%) and 6 out of 46 children (13%). The incidence of asymmetry was higher in adults during surgery (p = 0.0002). In conclusion, clinically relevant bispectral index asymmetry has been observed in > 10% of paediatric and adult anaesthesia and may have clinical implications. You can respond to this article at http://www.anaesthesiacorrespondence.com.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Fudickar
authors.forename: D
authors.initials: D
authors.lastname: Voss
authors.forename: G
authors.initials: G
authors.lastname: Serocki
authors.forename: W
authors.initials: W
authors.lastname: Jeckström
authors.forename: P
authors.initials: P
authors.lastname: Ambrosch
authors.forename: M
authors.initials: M
authors.lastname: Steinfath
authors.forename: B
authors.initials: B
authors.lastname: Bein
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001143:Arousal / Q000502:physiology; D002648:Child; D056805:Consciousness Monitors / Q000592:standards* / Q000706:statistics & numerical data; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008738:Methyl Ethers; D008874:Midazolam; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D011229:Preanesthetic Medication; D015742:Propofol; D012016:Reference Values; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D008874:Midazolam; D015742:Propofol