Bispectral Index Monitoring Documents Burst Suppression During Pentobarbital Coma

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During pentobarbital coma, electroencephalographic monitoring is used to document burst suppression (3–5 episodes of electrical activity/min). The current study evaluates the association of the bispectral index number and suppression ratio with a burst suppression pattern on electroencephalograph. The records of 7 patients (aged 2.9–14 years) who received pentobarbital for elevated intracranial pressure were retrospectively reviewed. The bispectral index number was 7 ± 5, 14 ± 3, and 37 ± 12, whereas the suppression ratio was 93 ± 7%, 75 ± 6%, and 29 ± 18% when the electroencephalograph showed > 2, 3–5, and < 6 bursts/min, respectively. The sensitivity and specificity of a bispectral index value of 10 to 20 were 96% and 92%, respectively, whereas the sensitivity and specificity of a suppression ratio of 65% to 85% were 89% and 88%, respectively, in demonstrating the presence of 3 to 5 bursts/min. Bispectral index monitoring may be easier to perform and may require less technical expertise to interpret.

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