BIS and spectral entropy monitoring during sedation with midazolam/remifentanil and dexmedetomidine/remifentanil

doi:10.1186/cc7776

Critical Care

Volume 13
Issue 2

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Commentary

BIS and spectral entropy monitoring during sedation with midazolam/remifentanil and dexmedetomidine/remifentanil

Anthony R Absalom and David K Menon

University Division of Anaesthesia, Addenbrookes Hospital, Cambridge CB2 2QQ, UK

author email corresponding author email

Critical Care 2009, 13:137doi:10.1186/cc7776


Published:	28 April 2009

See related research by Haenggi et al., http://ccforum.com/content/13/1/R20

Abstract

Haenggi and colleagues report considerable intra- and inter-individual variability in derived electroencephalogram (EEG) parameters (Bispectral Index (BIS), response entropy and state entropy) recorded in volunteers sedated with midazolam or dexmedetomidine infusions titrated to modified Ramsay scores of 2, 3 and 4, and a remifentanil infusion at a fixed target concentration. Possible explanations for the low, variable and fluctuating EEG parameters are that volunteers were intermittently asleep, and that remifentanil gave rise to a low amplitude, slowed EEG pattern despite maintained consciousness. BIS and entropy values should be interpreted in combination with clinical findings in patients sedated with these agents.