Considerations for Using BIS Monitoring
Clinical judgment should always be used when interpreting the BIS in conjunction with other
available clinical signs. Reliance on the BIS alone for intraoperative anesthetic management
is not recommended. As with any monitored parameter, artifacts and poor signal quality may
lead to inappropriate BIS values. Potential artifacts may be caused by poor skin contact (high
impedance), muscle activity or rigidity, head and body motion, sustained eye movements,
improper sensor placement and unusual or excessive electrical interference. Due to limited
clinical experience in the following applications, BIS values should be interpreted cautiously in
patients with known neurological disorders, those taking other psychoactive medications and in
children below the age of one.
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