title: Intraoperative aberrant bispectral index values due to facial nerve monitoring.
abstract: Bispectral index is an accepted depth of anaesthesia monitor for guiding intraoperative hypnotic agent administration. Frontalis EMG displayed on BIS monitor may increase due to twitching of frontalis muscle. EMG increases are also known to cause artefactual increases in BIS values. We report a case of artefactual increase of EMG and subsequently BIS values, due to electrical artefact from cranial nerve stimulator being used to identify the facial nerve. An explanation of the effect of stimulator signal on BIS EMG and BIS values has been provided.
authors.affiliation: Dept. of Neuroanaesthesia, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029, India. Electronic address: dhritiman.ch@gmail.com.
authors.forename: Dhritiman
authors.initials: D
authors.lastname: Chakrabarti
authors.affiliation: Dept. of Neuroanaesthesia, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029, India. Electronic address: rohinigondhule@gmail.com.
authors.forename: Rohini Mrugank
authors.initials: RM
authors.lastname: Surve
authors.affiliation: Dept. of Neuroanaesthesia, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029, India. Electronic address: bsdeepti@gmail.com.
authors.forename: Deepti
authors.initials: D
authors.lastname: Bs
authors.affiliation: Dept. of Neuroanaesthesia, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka 560029, India. Electronic address: dheerajmasapu@gmail.com.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Masapu
mesh_terms: D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D016477:Artifacts; D056805:Consciousness Monitors; D003399:Craniotomy; D004569:Electroencephalography; D004576:Electromyography; D005154:Facial Nerve / Q000502:physiology*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D004561:Transcutaneous Electric Nerve Stimulation; D014673:Vecuronium Bromide / Q000008:administration & dosage
chemical_list: D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D014673:Vecuronium Bromide; D005283:Fentanyl; D015742:Propofol
keywords: Artefact; Bispectral index; Facial nerve monitoring