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Bis

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23 views15 pages

Bis

Uploaded by

Nasir
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Bispectral Index® (BIS®)

EEG Analysis Methods


EEG Frequency Patterns
 Beta (13-30 Hz) Mental concentration

 Low doses of sedative


 Alpha (8-13Hz) Alert, relaxed

 Light anaesthesia
 Theta (4-8Hz) General anaesthesia

 Delta (<4Hz) Deep anaesthesia


Ischaemia
Overdose
Very ”deep” EEG Patterns
 Near-Suppression

 Burst-Suppression

 Isoelectric EEG
BIS Analysis Method
BIS: Application of Sensor
 Based on 1-channel EEG
 Either left or right hemisphere
BIS-XP Technology, with 4. electrode
 Improved artefact detection via internal 2. EEG channel
 Improved EMG
 Improved near-suppression handling
 Filter to stop electrocautery interaction (Bovie resistance)

Unconsciou Awake Eye Blinks


s

EEGs are typically Artifacts are typically


symmetrical asymmetrical
BIS Analysis Method
How to understand the BIS value

 Numerics:
 BIS = Bispectral Index
 SQI = Signal Quality Index
 SR = Suppression Ratio
 SEF = Spectral Edge Frequency
 TP = Total Power
 Muscle activity:
 EMG (Electromyographic Power)
Summary--What is BIS?
 A practical EEG that measures the direct
effects of sedation on the brain
 Provides objective clinical information
about your patient’s sedation status
 Enables you to deliver more
precise sedation
 Patient and drug independent
Sensor Application
 Apply sensor on forehead
at angle
 Circle #1: Centered, 2 inches 2 Inches
above nose (5cm)
 Circle #4: Above/Adjacent to
eyebrow
 Circle #3: Either temple between
corner of eye and hairline
 Press edges of sensor
 Circle all 4 elements

 Press each circle for 5 seconds


 Use fingertip
 Press firmly
 成人传感器

BIS Sensors 

电极 1 为参考电极；
电极 2 为地电极；
 电极 3 （正电极）和 4 （负电极）为信号电极。
 电极 1+3 为通道 1 ，电极 1+4 为通道 2
Quatro

 小儿传感器
 电极 1 为参考电极；
 电极 2 为地电极；
 电极 3 （负电极）为信号电极。电极 1+3 组成一个通道
Pediatric

Semi-reusable
Notes
Specification:
 The numeric BIS index is updated every (1) second
 Each BIS value is based on EEG data from the previous 15 or 30
seconds, depending on smoothing rate the
 Response time: 7.5 to 30 seconds, depending on smoothing rate and
artefacts

Smoothing Rate
 15s, 30s

Wave scale setup


 Sensor Check (Default on.)
The combined impedance of the signal electrodes plus the reference el
ectrode: Continuously and does not affect the EEG wave.
The impedance of the ground electrode: every ten minutes and takes ap
proximately four seconds, causes an artifact in the EEG wave, and the m
essage [BIS Ground Checking] is displayed

 Cyclic Impedance Check


The exact impedance of each individual electrode, causes a disturbed
EEG wave.
① is the reference electrode

② the ground electrode

③ and ④ are signal electrodes


Tips For Success
BIS
BIS has
has aa 15-30
15-30 second
second BIS
BIS is
is aa brain
brain monitor
monitor
averaging
averaging time
time
More
More deeply
deeply sedated
sedated
patients
patients are
are best
best
BIS
BIS is
is not
not aa movement
movement candidates
candidates for
for BIS
BIS
monitor
monitor monitoring
monitoring

BIS
BIS does
does not
not always
always
correlate
correlate
with
with BP/HR
BP/HR changes
changes
Interpret
Interpret BIS
BIS value
value in
in
conjunction
conjunction with
with other
other BIS
BIS does
does not
not replace
replace
available
available information
information and
and peripheral
peripheral Nerve
Nerve
over
over time
time stimulator
stimulator

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