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Related Experiment Videos

Paradoxical changes in bispectral index during nitrous oxide administration.

G D Puri1

  • 1Department of Anesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

British Journal of Anaesthesia
|September 29, 2001
PubMed
Summary

High bispectral index (BIS) values were observed during open heart surgery with nitrous oxide and isoflurane anesthesia. Stopping nitrous oxide decreased BIS, while restarting it increased BIS, indicating its effect on monitoring.

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Authors' response.

The Indian journal of medical research·2022

Area of Science:

  • Anesthesiology
  • Neurophysiology
  • Surgical Monitoring

Background:

  • Bispectral index (BIS) monitoring is used to assess depth of anesthesia.
  • Nitrous oxide and isoflurane are common anesthetic agents used in open heart surgery.
  • Accurate BIS monitoring is crucial for patient safety during complex procedures.

Observation:

  • Two patients undergoing open heart surgery presented with unexpectedly high BIS values.
  • These high BIS values were recorded during combined anesthesia with nitrous oxide and isoflurane.
  • A direct correlation between the administration of nitrous oxide and elevated BIS readings was noted.

Findings:

  • Discontinuation of nitrous oxide led to an immediate decrease in BIS values.
  • Reintroduction of nitrous oxide resulted in a prompt increase in BIS values.

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  • These findings suggest nitrous oxide significantly influences BIS readings in this anesthetic context.

    • Implications:

    • The study highlights a potential confounding effect of nitrous oxide on BIS monitoring.
    • Anesthesiologists should be aware of this interaction to avoid misinterpretation of BIS values.
    • Further research may be needed to refine BIS monitoring protocols when nitrous oxide is used in cardiac surgery.