Can BIS monitoring be used to assess the depth of propofol anesthesia in the treatment of refractory status epilepticus?

Purpose:  Appropriate treatment of generalized convulsive refractory status epilepticus (RSE) requires general anesthesia in the intensive care unit (ICU) with continuous electroencephalography (cEEG) monitoring. During out of office hours and weekends, cEEG monitoring is not always available. The Bispectral Index (BIS) monitor can be used to assess the hypnotic component of general anesthesia. We conducted a study to evaluate the feasibility of using the BIS monitoring to assess the burst suppression (BS) pattern during propofol anesthesia in RSE.

[1]  S. Shorvon,et al.  EFNS guideline on the management of status epilepticus in adults , 2010, European journal of neurology.

[2]  C. Wasterlain,et al.  Status epilepticus: pathophysiology and management in adults , 2006, The Lancet Neurology.

[3]  S. Gautam,et al.  Duration of refractory status epilepticus and outcome: Loss of prognostic utility after several hours , 2009, Epilepsia.

[4]  J. Bruhn,et al.  Depth of anaesthesia monitoring: what's available, what's validated and what's next? , 2006, British journal of anaesthesia.

[5]  B. Mourvillier,et al.  Outcomes in 140 critically ill patients with status epilepticus , 2007, Intensive Care Medicine.

[6]  G. Fraser,et al.  Comparing the Bispectral Index and Suppression Ratio with Burst Suppression of the Electroencephalogram During Pentobarbital Infusions in Adult Intensive Care Patients , 2003, Pharmacotherapy.

[7]  J. Johansen,et al.  Update on bispectral index monitoring. , 2006, Best practice & research. Clinical anaesthesiology.

[8]  F. Drislane,et al.  Depth of EEG Suppression and Outcome in Barbiturate Anesthetic Treatment for Refractory Status Epilepticus , 1999, Epilepsia.

[9]  S. Hamada,et al.  Seizure after aortic clamp release: a bispectral index pitfall. , 2008, Journal of cardiothoracic and vascular anesthesia.

[10]  Françoise Masson,et al.  The Use of Bispectral Index to Monitor Barbiturate Coma in Severely Brain-Injured Patients with Refractory Intracranial Hypertension , 2008, Anesthesia and analgesia.

[11]  S. Shorvon,et al.  EFNS guideline on the management of status epilepticus , 2006, European journal of neurology.

[12]  S. Moshé,et al.  How do seizures stop? , 2008, Epilepsia.

[13]  Esa Mervaala,et al.  Propofol in the treatment of refractory status epilepticus , 2006, Intensive Care Medicine.

[14]  Jan Claassen,et al.  Treatment of Refractory Status Epilepticus with Pentobarbital, Propofol, or Midazolam: A Systematic Review , 2002, Epilepsia.

[15]  A. Yli-Hankala,et al.  Quantification of Epileptiform Electroencephalographic Activity during Sevoflurane Mask Induction , 2007, Anesthesiology.

[16]  R. Kälviäinen,et al.  Refractory Generalised Convulsive Status Epilepticus , 2005, CNS drugs.

[17]  L. Metsähonkala,et al.  Epileptiform discharges during 2 MAC sevoflurane anesthesia in two healthy volunteers. , 1999, Anesthesiology.

[18]  Joseph D Tobias.  Bispectral Index Monitoring Documents Burst Suppression During Pentobarbital Coma , 2008, Journal of intensive care medicine.

[19]  Thomas W. Bouillon,et al.  Bispectral Index (BIS) and Burst Suppression: Revealing a Part of the BIS Algorithm , 2004, Journal of Clinical Monitoring and Computing.

[20]  J. Blok,et al.  Continuous noninvasive monitoring of barbiturate coma in critically ill children using the Bispectral™ index monitor , 2007, Critical care.

[21]  Nonconvulsive status and bispectral index. , 2008, Critical care medicine.

[22]  E. Alsina,et al.  Utilidad clínica del bis y la entropía para la detección de crisis epilépticas , 2008 .

[23]  M. Hayashida,et al.  Change in bispectral index during epileptiform electrical activity under sevoflurane anesthesia in a patient with epilepsy. , 2004, Anesthesia and analgesia.

[24]  D. Treiman,et al.  The role of the newer antiepileptic drugs in the treatment of generalized convulsive status epilepticus , 2008, Epilepsia.

[25]  M. Baulac,et al.  The drug treatment of status epilepticus in Europe: Consensus document from a workshop at the first London Colloquium on Status Epilepticus , 2008, Epilepsia.

[26]  E. Ruokonen,et al.  High-dose thiopental in the treatment of refractory status epilepticus in intensive care unit , 2002, Neurology.

[27]  KathleenW. Wyrwich,et al.  Continuous or emergent EEG: can bedside caregivers recognize epileptiform discharges? , 2004, Intensive Care Medicine.

[28]  M. J. Schwabe,et al.  Use of an anesthesia cerebral monitor bispectral index to assess burst-suppression in pentobarbital coma. , 2003, Pediatric neurology.