Understanding the effectiveness of BIS parametric model for monitoring sedation and depth of anesthesia in pediatric surgery

Current studies confirm that the Bispectral Index (BIS) has better correlation with sedation and depth of anesthesia among older children. In reverse to the concentration of anesthetic drugs, BIS can evaluate the level of consciousness. But for babies, the monitoring effectiveness of BIS still needs further study. Bispectral index (BIS) algorithms are based on the integrated analysis of the original electroencephalogram (EEG) data from a large number of healthy adult volunteers that were under different concentrations of anesthetic drugs and different clinical critical points such as loss of consciousness, awakening, endotracheal intubation, among others. Alarge number of clinical studies has shown that under Propofol, midazolam, Sevoflurane, and Isoflurane anesthesia, BIS and sedation score (OAA/S) aswell as language instruction response presented a good correlation. But BIS cannot effectively predict injuries due to movement response triggered by noxious stimulation because movement response due to noxious stimulation is mediated by the spinal cord, whereas BIS responds to the electrical activity of the cerebral cortex and anesthesia sedation ingredients. Further studies reveal that with BIS monitored anesthesia, there is less anesthetic usage, and faster post-operation recovery, with less incidence of intra-operative awareness. As a result of these advantages, BIS application in clinical studies is also extended to pediatric patients. But it is still unclear if BIS monitoring devices and algorithms for adults are applicable to pediatric patients. A newborn's electroencephalogram (EEG) is different from an adult. Brain maturation and neuronal synapse formation of a child continue until 5 years of age. Therefore the goal of this study is to establishing a monitoring model for pediatric purposes.