Document Detail

An alternative position for the BIS-Vista montage in frontal approach neurosurgical cases.
MedLine Citation:
PMID:  23456030     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Appropriate placement of the bispectral index (BIS)-vista montage for frontal approach neurosurgical procedures is a neuromonitoring challenge. The standard bifrontal application interferes with the operative field; yet to date, no other placements have demonstrated good agreement. The purpose of our study was to compare the standard BIS montage with an alternate BIS montage across the nasal dorsum for neuromonitoring.
MATERIALS AND METHODS: The authors performed a prospective study, enrolling patients and performing neuromonitoring using both the standard and the alternative montage on each patient. Data from the 2 placements were compared and analyzed using a Bland-Altman analysis, a Scatter plot analysis, and a matched-pair analysis.
RESULTS: Overall, 2567 minutes of data from each montage was collected on 28 subjects. Comparing the overall difference in score, the alternate BIS montage score was, on average, 2.0 (6.2) greater than the standard BIS montage score (P<0.0001). The Bland-Altman analysis revealed a difference in score of -2.0 (95% confidence interval, -14.1, 10.1), with 108/2567 (4.2%) of the values lying outside of the limit of agreement. The scatter plot analysis overall produced a trend line with the equation y=0.94x+0.82, with an R coefficient of 0.82.
CONCLUSIONS: We determined that the nasal montage produces values that have slightly more variability compared with that ideally desired, but the variability is not clinically significant. In cases where the standard BIS-vista montage would interfere with the operative field, an alternative positioning of the BIS montage across the nasal bridge and under the eye can be used.
Priscilla Nelson; Jonas A Nelson; Alexander J Chen; W Andrew Kofke
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  25     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-04     Completed Date:  2013-08-26     Revised Date:  2014-07-16    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-42     Citation Subset:  IM    
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MeSH Terms
Consciousness Monitors*
Data Interpretation, Statistical
Frontal Lobe / surgery*
Monitoring, Intraoperative
Nasal Cavity
Neurosurgical Procedures / methods*
Prospective Studies
Comment In:
J Neurosurg Anesthesiol. 2014 Jul;26(3):265-7   [PMID:  24445425 ]
J Neurosurg Anesthesiol. 2014 Jul;26(3):263-4   [PMID:  24275938 ]

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