Validation of the Bispectral Index Monitor for Measuring the Depth of Sedation in Children
Senthilkumar Sadhasivam, Arjunan Ganesh, Amy Robinson, Robin Kaye, and Mehernoor F. Watcha
(Anesth Analg, 102:383-388, 2006)
Departments of Anesthesiology and Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
The bispectral index (BIS), an empirically calibrated number derived from adult electroencephalographic data, correlates with the depth of sedation in adults. The hypothesis was tested that the BIS score is a valid measure of the depth of pediatric sedation in a study designed to avoid the limitations of a previously published report. The BIS values from 96 healthy American Society of Anesthesiologists physical status I and II children aged 1 to 12 years undergoing sedation were continuously recorded and electronically transferred to a computer. The sedation was evaluated using the Observer's Assessment of Alertness/Sedation (OAA/S) and the University of Michigan Sedation Scale (UMSS) at 3- to 5-minute intervals by 2 independent observers blinded to the BIS score. A marked correlation existed between BIS values and UMSS and between BIS values and OAA/S by both Spearman rank correlation test and prediction probability. In children younger than 6 years, a notable correlation was present between BIS values and the clinical sedation scores for subgroups undergoing invasive and noninvasive procedures. Good agreement existed between the 2 independent observers who assessed clinical sedation scores (κ = 0.51). The investigators concluded that the BIS monitor is a quantitative, nondisruptive, and easy-to-use depth-of-sedation monitor in children.