[Correlation of bispectral index (BIS) monitoring and end-tidal sevoflurane concentration in a patient with lobar holoprosencephaly].
OBJECTIVE
The bispectral index (BIS) is a parameter derived by electroencephalography (EEG) which provides a direct measurement of the effects of sedatives and anesthetics on the brain and offers guidance on the adequacy of anesthesia. The literature lacks studies on BIS monitoring in pediatric patients with congenital brain disease undergoing general anesthesia.


METHODS
A 13-year-old child weighing 32kg, suffering from lobar holoprosencephaly, underwent surgery in which the bispectral index (BIS) monitoring the depth of anesthesia showed an abnormal response. Detailed analysis of the trends of BIS values in the different observation times demonstrated sudden falls and repetitive values of BIS likely related to repetitive epileptiform electrical activity caused by sevoflurane.


CONCLUSIONS
The BIS is a very useful monitoring tool for assessing the degree of depth of anesthesia and to analyze the electroencephalographic variations of anesthetics. Particular attention should be given to patients with congenital disorders of the central nervous system in which the BIS may give abnormal responses that do not reflect an accurate assessment of the depth of anesthesia.
Departamento de Anestesia e Tratamento Intensivo, Hospitais Reunidos, Foggia, Itália. Electronic address: dario.galante@tin.it.
Dario
D
Galante
Departamento de Anestesia e Tratamento Intensivo, Hospitais Reunidos, Foggia, Itália.
Donatella
D
Fortarezza
Departamento de Anestesia e Tratamento Intensivo, Hospitais Reunidos, Foggia, Itália.
Maria
M
Caggiano
Departamento de Anestesia e Tratamento Intensivo, Hospital Agostino Gemelli, Universidade Católica do Sagrado Coração, Roma, Itália.
Giovanni
G
de Francisci
Departamento de Anestesia e Tratamento Intensivo, Hospital S. Chiara, Trento, Itália.
Dino
D
Pedrotti
Departamento de Anestesia e Tratamento Intensivo, Hospital Infantil La Timone, Marselha, França.
Marco
M
Caruselli
Bispectral index; Convulsões; Holoprosencefalia; Holoprosencephaly; Seizures; Sevoflurane; Sevoflurano; Índice bispectral