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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Idiopathic decreased bispectral index during anaesthesia emergence: Possible cau...
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Vol. 64. Issue 8.
Pages 472-475 (October 2017)
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Vol. 64. Issue 8.
Pages 472-475 (October 2017)
Case report
Idiopathic decreased bispectral index during anaesthesia emergence: Possible causes for the phenomenon of paradoxical arousal
Disminución idiopática del índice biespectral durante la educción anestésica: posibles causas del fenómeno delta paradójico
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J. Zaldibar-Gerrikagoitia Bilbaoa,
Corresponding author
, J. González Garcíab, O. Romero Menchacab, A. Bernas Albeniza, L. Aguilera Celorrioc
a Medicina Interna (Residencia), Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
b Medicina Adjunta, Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
c Servicio de Anestesiología y Reanimación, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
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Abstract

In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, β waves) as would be expected, but leads to a slowed electroencephalogram pattern instead.

We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event.

Keywords:
Electroencephalography
Consciousness monitors
Intraoperative monitoring
Acoustic stimulation
Resumen

En un pequeño porcentaje de pacientes, la estimulación sonora, táctil e incluso nociceptiva en presencia de una ligera profundidad anestésica no provoca la aparición de ondas cerebrales propias de la activación cerebral (ondas α, β), sino que desencadena un enlentecimiento del trazado de las ondas del electroencefalograma.

Presentamos el caso de una paciente en la que se registra una actividad cerebral muy enlentecida en el electroencefalograma procesado del monitor del índice biespectral, así como una disminución del valour algorítmico, que dura aproximadamente 5min en el momento de la educción anestésica, coincidiendo con la estimulación sonora y táctil, que tras mantenerla en observación durante 24h en el postoperatorio, no coincide con ningún trastorno a nivel cerebral que lo pueda justificar.

Palabras clave:
Electroencefalografía
Monitores de consciencia
Monitorización intraoperatoria
Estimulación

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