title: Changes in the Bispectral Index in Response to Experimental Noxious Stimuli in Adults under General Anesthesia.
abstract: Objective. Pain assessment is a major challenge in nonverbal patients in the intensive care unit (ICU). Recent studies suggest a relationship between the Bispectral Index (BIS) and nociceptive stimuli. This study was designed to examine changes in BIS in response to experimental noxious stimuli. Methods. Thirty participants under general anesthesia were in this quasiexperimental, within subject, pre- and poststudy. In the operating room (OR), BIS was monitored during moderate and severe noxious stimuli, induced by a thermal probe on the participants' forearm, after induction of general anesthesia, prior to surgery. Results. Significant increases in BIS occurred during moderate (increase from 35.00 to 40.00, P = 0.003) and severe noxious stimuli (increase from 37.67 to 40.00, P = 0.007). ROC showed a sensitivity (Se) of 40.0% and a specificity (Sp) of 73.3% at a BIS value > 45, in distinguishing a moderate from a severe noxious stimuli. Conclusion. BIS increased in response to moderate and severe noxious stimuli. The Se and Sp of the BIS did not support the use of the BIS for distinction of different pain intensities in the context of deep sedation in the OR. However, the results justify further studies in more lightly sedated patients such as those in the ICU.
authors.affiliation: School of Nursing, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1; Sherbrooke University Hospital (CHUS), Sherbrooke, QC, Canada J1H 1P8.
authors.forename: Robin Marie
authors.initials: RM
authors.lastname: Coleman
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1; Centre de Recherche Clinique Étienne-Le Bel du Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada J1H 5N4.
authors.forename: Yannick
authors.identifier: 0000-0002-1133-8707
authors.initials: Y
authors.lastname: Tousignant-Laflamme
authors.affiliation: School of Nursing, McGill University, Montreal, QC, Canada H3A 0G4; Center for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada H3T 1E2.
authors.forename: Céline
authors.initials: C
authors.lastname: Gélinas
authors.affiliation: Department of Anesthesiology, School of Medicine, University of Montreal, Montreal, QC, Canada H3C 3J7.
authors.forename: Manon
authors.initials: M
authors.lastname: Choinière
authors.affiliation: Department of Anesthesiology, School of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1.
authors.forename: Maya
authors.identifier: 0000-0003-2931-3740
authors.initials: M
authors.lastname: Atallah
authors.affiliation: School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Parenteau-Goudreault
authors.affiliation: Centre de Recherche Clinique Étienne-Le Bel du Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada J1H 5N4; Department of Anesthesiology, School of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada J1K 2R1.
authors.forename: Patricia
authors.initials: P
authors.lastname: Bourgault