Abstract
We report the case of a patient with drug resistant epilepsy scheduled for amygdalohippocampectomy (AHS). During this type of surgery, Density Spectral Array (DSA) belonging to the Bilateral Bispectral Index (BIS) VISTATM Monitoring System (BVMS) was used. DSA, but no BIS trend, was helpful to detect differences in the power spectrum between both cerebral hemispheres during propofol- remifentanyl-dexmedetomidine anesthesia. This case provides novel evidence to support the clinical utility of DSA in monitoring depth of anaesthesia and sedation.
Highlights
Anaesthesiologists use sedative drugs, opioids, hypnotics and neuromuscular blocking agents to induce and maintain general anaesthesia, monitoring cardiovascular, respiratory and EEG parameters all along the procedure
Asymmetry (ASYM) is a processed variable indicating the percentage of EEG power present in left or right hemispheres with respect to total EEG power [1]
Asymmetry graphical data may be plotted as part of the Density Spectral Array (DSA) display
Summary
Anaesthesiologists use sedative drugs, opioids, hypnotics and neuromuscular blocking agents to induce and maintain general anaesthesia, monitoring cardiovascular, respiratory and EEG parameters all along the procedure. This monitor shows changes in the power spectrum distribution through the Density Spectral Array (DSA). Anaesthesia was maintained with infusions of propofol (2.11 mg/kg/h), remifentanyl (0.06 mcg/kg/min), and dexmedetomidine (0.3 mcg/kg/min) to keep BIS values within 45-60 range. At the beginning of the procedure, DSA displayed a SEF 95 higher than 20 Hz; the anesthetic induction drastically decreased this value, while the alpha band appeared (Figure 1A).
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