title: Idiopathic decreased bispectral index during anaesthesia emergence: Possible causes for the phenomenon of paradoxical arousal.
abstract: In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, β waves) as would be expected, but leads to a slowed electroencephalogram pattern instead. We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event.
authors.affiliation: Medicina interna (residencia), Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, España. Electronic address: josu.zaldibar-gerrikagoitiabilbao@osakidetza.net.
authors.forename: J
authors.initials: J
authors.lastname: Zaldibar-Gerrikagoitia Bilbao
authors.affiliation: Medicina adjunta, Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
authors.forename: J
authors.initials: J
authors.lastname: González García
authors.affiliation: Medicina adjunta, Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
authors.forename: O
authors.initials: O
authors.lastname: Romero Menchaca
authors.affiliation: Medicina interna (residencia), Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
authors.forename: A
authors.initials: A
authors.lastname: Bernas Albeniz
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, España.
authors.forename: L
authors.initials: L
authors.lastname: Aguilera Celorrio
mesh_terms: D000368:Aged; D001143:Arousal; D056805:Consciousness Monitors; D055191:Delayed Emergence from Anesthesia / Q000175:diagnosis / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis; D007044:Hysterectomy; D010812:Physical Stimulation; D014594:Uterine Neoplasms / Q000601:surgery
keywords: Acoustic stimulation; Consciousness monitors; Electroencefalografía; Electroencephalography; Estimulación; Intraoperative monitoring; Monitores de consciencia; Monitorización intraoperatoria