A study of the Bispectral Index Monitor during procedural sedation and analgesia in the emergency department

Abstract

Study objectives: The Bispectral Index Monitor has been validated as an objective Meas. of sedation depth in the operating room; however, its value for states other than Gen. anesthesia remains unclear. We hypothesized that bispectral index monitoring would reliably correlate with traditional definitions of sedation depth in emergency Dept. patients undergoing procedural sedation/analgesia. Methods: In this prospective observational Stud. we measured the Bispectral Index score and a modified Ramsay Sedation Scale score every 5 minutes in a convenience sample of adult ED patients undergoing procedural sedation and analgesia. Investigators and treating physicians were blinded to Bispectral Index scores, which were later correlated with modified Ramsay Sedation Scale scores. We constructed receiver operating characteristic curves to determine the most discriminatory Bispectral Index score thresholds for sedation depth. Results: Two hundred seventy paired readings were obtained from 37 patients. Despite being statistically significant (P