Application of bilateral bispectral index monitoring during embolization of intracranial aneurysm

Yu Bin; Mei Hongxun

doi:10.3760/cma.j.issn.1673-4777.2015.08.015

Abstract：Objective To investigate the changes of bilateral bispectral index (BIS) during embolization of intracranial aneurysm.Methods Ten patients with subarachnoid hemorrhage from April 2013 to April 2014 who underwent embolization of intracranial aneurysm within 72 h were enrolled.The bilateral BIS,invasive mean arterial blood pressure (MAP) and heart rate (HR) were monitored continuously five minutes before anesthesia (T1),when micro catheter navigated to the site of the aneurysm (T2),coils deployed to fill the aneurysm (T3) and coil embolization completed (T4).Results The bilateral BIS value was lower on the side of operation than that on the opposite side at T1 in 1 case (No.10) (83.4 ± 3.2 vs 92.0 ± 3.9,P ＜ 0.05),in 2 cases (No.1 and 10) at T2 (41.6 ± 2.7 vs 48.6±4.6,38.2 ±4.6 vs42.4±3.4,P＜0.05),in5 cases (No.1,5,8,9 and 10) at T3(46.4±2.7 vs 53.4±4.3,41.8±1.3 vs 49.0 ±2.6,41.4±1.3 vs 46.4±3.0,36.6 ±3.4 vs 41.8±2.4,41.8 ±2.4 vs 45.4 ± 2.9,P＜0.05),and in 6 cases (No.1,2,3,5,9,10) at T4(41.2±1.6 vs 53.8 ±3.8,40.2 ± 1.6 vs 44.6 ± 3.1,42.0±5.8 vs50.6 ±6.7,42.4 ±1.5 vs46.4±1.1,36.6±0.8 vs42.4 ±2.5,44.4±5.6 vs48.2±4.8,P＜ 0.05).There were no significantly differences regarding variables of BIS,MAP and HR among T2,T3 and T4.Two patients (No.1 and 10) had cerebral infarction after operations.Conclusion The difference of BIS values between operation side and the opposite side of the brain during embolization of intracranial aneurysm is a good indicator for cerebral ischemia,which is associated with poor postoperative neurologic function.