Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942007000400005
Brazilian Journal of Anesthesiology
Scientific Article

Comparação dos valores do índice bispectral em pacientes com paralisia cerebral em estado de vigília

Comparison of the bispectral index in awake patients with cerebral palsy

Verônica Vieira da Costa; Rafael Villela S. D. Torres; Érika Carvalho Pires Arci; Renato Ângelo Saraiva

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Resumo

JUSTIFICATIVA E OBJETIVOS: O EEG-BIS foi criado por meio de estudos em pacientes adultos saudáveis e as primeiras publicações em crianças surgiram a partir de 1998. A paralisia cerebral (PC) é secundária à lesão estática do encéfalo em desenvolvimento. A necessidade de realização de exames e procedimentos cirúrgicos para correção de deformidades sob anestesia ou sedação é comum nesses pacientes. Torna-se cada vez mais necessária a monitorização do estado de hipnose do paciente anestesiado e pode-se incluir nesse grupo os pacientes com paralisia cerebral. O objetivo desse estudo foi avaliar a eficiência do EEG-BIS nos pacientes com paralisia cerebral (PC) em comparação com os pacientes sem doenças neurológicas (sem PC), em estado de vigília. MÉTODO: Foram avaliados dois grupos de pacientes: um com diagnóstico de paralisia cerebral e outro sem doença do sistema nervoso central (SNC). Na véspera da intervenção cirúrgica, na enfermaria, junto aos pacientes despertos era colocado o monitor de EEG-BIS e solicitado que fechassem os olhos. Os valores que apareciam na tela do monitor, em um intervalo de 10 minutos, eram anotados e registrados em ficha padronizada, sendo calculado um valor médio por paciente. RESULTADOS: Foram avaliados 188 pacientes, de ambos os sexos, com idade média de 10, 07 ± 2,9 (PC) e 10,21 ± 3,1 (sem PC) anos. O grupo PC apresentou EEG-BIS basal de 95,83 ± 5,142 e o grupo sem PC de 96,56 ± 1,941 sem haver diferença estatística significativa entre eles. CONCLUSÕES: Os sinais de EEG são captados normalmente e os valores de EEG-BIS dos pacientes com PC são semelhantes ao dos pacientes sem PC no estado de vigília.

Palavras-chave

DOENÇAS, MONITORIZAÇÃO

Abstract

BACKGROUND AND OBJECTIVES: The EEG-BIS was created after studies in healthy adult subjects, and studies in children were first published in 1998. Cerebral palsy (CP) is secondary to a static lesion of the developing brain. The need to perform exams and surgical procedures to correct deformities, under anesthesia or sedation, is common in these patients. The need for monitoring of the hypnotic state in anesthetized patients has increased; patients with cerebral palsy can be included in this group of patients. The objective of this study was to evaluate the efficacy of the awake EEG-BIS in patients with cerebral palsy (CP) by comparing it with patients without neurological disorders (without CP). METHODS: Two groups of patients were evaluated: one composed of patients with the diagnosis of cerebral palsy, and the other with subjects without central nervous system (CNS) disorders. The day before the surgery, hospitalized patients were connected to the EEG-BIS monitor and were asked to close their eyes. The values on the monitor were recorded at 10-minute intervals on a standard form, and the mean value for each patient was calculated. RESULTS: One hundred and eighty-eight patients of both genders, mean age of 10.07 ± 2.9 (CP) and 10.21 ± 3.1 (without CP), were evaluated. The basal EEG-BIS of the PC group was 95.83 ± 5.142 and in the non-CP group was 96.56 ± 1.941, which did not demonstrate a statistically significant difference. CONCLUSIONS: The signals of the EEG are captured normally and the values of the awake EEG-BIS of CP patients are similar to that of non-CP patients.

Keywords

DISEASES, MONITORIZATION

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