FORENSIC TOXICOLOGY

The bispectral index (BIS) summarizes features of the electroencephalogram. The Modified Observer’s Assessment of Alertness/Sedation scale scores a patient’s response to stimulation. A prospective study compared these measures during the first five minutes of induction with remimazolam and sufentanil.

Correlation and agreement answer different questions

The measures showed a moderate correlation early in induction, which weakened with time. The study also tested whether BIS below 60 agreed with a bedside score of zero. Agreement was slight, with a kappa of 0.175. The two readings could therefore track each other to a degree while classifying the same observation differently.

How to review a recorded index

Compare the monitor value with the bedside response documented at the same time and note the drugs and phase of induction. The findings apply to this regimen and short observation window. A single index value cannot substitute for the responsiveness assessment in this study.

Source

Zheng et al., Frontiers in Medicine · Full text