BIS Monitor

Published

I was shadowing a CRNA the other day and he happened to use a BIS Monitor on the patients he had for the day. He is the first person I have shadowed in the OR that has use one. His reason for using it was "Since we have it available, I just use it as an additional monitor." I know there is not conclusive evidence proving their reliability, but I was curious as to what others currently practicing (CRNA/SRNA) think about the monitor and its usefullness.

Up Vote Up Vote ×

personally i haven't used it very much but i did yesterday. i think it is just another consideration. i was running my patient at a 0.8 MAC of des with additional narcotic, his vitals were within 10% of pre-op with the hr a little lower than i would have liked but acceptable, but his BIS for 26-30. so according to the machine i had the pt too deep. but if i changed anything i expected his bp to rise and i didn't want that, plus i don't like to run my pt lower than a 0.8mac of gas. so i checked with my crna and she agreed to keep the pt where he was. so you can monitor the BIS but it's not the only thing you look at. imho.

Up Vote Up Vote ×

I agree with your CRNA. I have used the BIS monitor on several occassions for extremely critical patient on BiVAD in the ICU. If you have it why not used it.

Up Vote Up Vote ×
I agree with your CRNA. I have used the BIS monitor on several occassions for extremely critical patient on BiVAD in the ICU. If you have it why not used it.

We don't use it because there's no proof it does what it purports to do. It's basically voodoo at the moment. ;) Hey, you knew someone would say it.

Up Vote Up Vote ×
Specializes in Critical Care.

The current CCU that I work in doesn't have BIS available, but the last one did. I was only 1 of 2 nurses to routinely use it on paralyzed pts.

I understand that it may be of limited value, but a constant monitor is more valuable, in my opinion, than an occasional use of a neurostimulator.

And I agree that - treat the pt not the monitor - is important in any case, but more important regarding BIS.

~faith,

Timothy.

Up Vote Up Vote ×

I understand that it may be of limited value, but a constant monitor is more valuable, in my opinion, than an occasional use of a neurostimulator.

You do know that the BIS and a neurostim measure two different things, right? (at least if the BIS does what it's supposed to).

Up Vote Up Vote ×

if i had a bis i would use it - and when one has been available i take advantage even though there is no solid proof that it prevents recall - what can it hurt...

i am however very very glad that i have learned to do anesthesia without the bis - i think it is of utmost importance to know where your patient is anesthetic wise without it - i feel those trained with it may be at a disadvantaged learning curve if they decide to work somewhere without it... could be wrong of course - just an opinion.

Up Vote Up Vote ×

I heard that somebody got a BIS of >90 off a bowl of Jello!!! How about that BetaRatio parameter. Conclusion: More research into the subject needed, with less N=Jello!!! hehehe

Up Vote Up Vote ×
Specializes in Critical Care.
You do know that the BIS and a neurostim measure two different things, right? (at least if the BIS does what it's supposed to).

Yes, I suppose I do realize that.

We used to give sedation and paralytics at the same times. These days, it seems like everybody's on a diprivan gtt regardless.

~faith,

Timothy.

Up Vote Up Vote ×
We don't use it because there's no proof it does what it purports to do. It's basically voodoo at the moment. ;) Hey, you knew someone would say it.

Not voodoo but "oh no!" is what you'll be saying if the pt is improperly anesthetized or sedated and you chose not to use the available BIS monitor. Use ALL the tools at our disposal. I've experienced good/consistent results with careful attachment and integrating data with standard assessment. Didn't mean to speech at you. Just thinking out loud.

Up Vote Up Vote ×

why would he say OH NO -

the BIS is not a standard of care and therefore it is a choice whether to use it or not. proper anesthetic level should not be guided by something that has of yet not been scientifically tested and proven to work (other than by the manufacturers)

Up Vote Up Vote ×
why would he say OH NO -

the BIS is not a standard of care and therefore it is a choice whether to use it or not. proper anesthetic level should not be guided by something that has of yet not been scientifically tested and proven to work (other than by the manufacturers)

Thank you brother (or sister) - tell it like it is!!! :bow:

Up Vote Up Vote ×
+ Join the Discussion