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The bispectral index (BIS) monitor is an electroen-cephalographic recording device that generates a single numeric value. It has traditionally been used to measure anesthetic depth and avoid awareness in the operating room setting. In this report, the authors present different scenarios in the pediatric intensive care unit that demonstrate the potential applications of the BIS monitor outside of the operating room setting. The scenarios presented include use of the BIS monitor during titration of barbiturate coma, procedural sedation, sedation assessment during mechanical ventilation, and sedation while administering potentially confounding medications. Previous reports regarding the use of the BIS monitor in such scenarios and potential future applications are reviewed.