BeneVision N22/N19 Patient Monitor Operator’s Manual 27 - 3
• The clinical utility, risk/benefit and application of the BIS component have not undergone full
evaluation in the pediatric population.
• For patients with neurological disorders, patients taking psychoactive medication, and children
under one year old, BIS values should be interpreted cautiously.
• Due to limited clinical experience in patients with known neurological disorders and those taking
psychoactive medications, the BIS value should be interpreted cautiously.
• The BIS monitoring is a complex technology, intended for use only as an adjunct to clinical
judgment and training. Clinical judgment should always be used when interpreting BIS in
conjunction with other available clinical signs. Reliance on BIS alone for intraoperative anesthetic
management is not recommended.
• Misinterpretation of BIS can result in incorrect administration of anesthetic agents and/or other
potential complications of anesthesia or sedation.
• BIS values should be interpreted cautiously with certain anesthetic combinations, such as those
relying primarily on either ketamine or nitrous oxide/narcotics to produce unconsciousness.
• Ensure that the BISx or BISx4 does not come into prolonged contact with your patient's skin, as it
may generate heat and cause discomfort.
• Do not use the BIS sensor if the sensor gel is dry. To avoid dryout, do not open the pack until you are
ready to use the sensor.
• When using electro-convulsive therapy (ECT) equipment during BIS monitoring, place ECT
electrodes as far as possible from the BIS sensor to minimize the effect of interference. Certain ECT
equipment may interfere with the proper function of the BIS monitoring system. Check for
compatibility of equipment during patient setup.
• The BIS measurement based on measuring the EEG signal is inherently very sensitive. Do not use
electrical radiating equipment close to the BISx or BISx4.
• Artifact may lead to inappropriate BIS values. Potential artifact may be caused by unusual or
excessive electrical interference or high EMG activity like shivering, muscle activity or rigidity,
sustained eye movements, head and body motion. Also, improper sensor placement and poor skin
contact (high impedance) may cause artifact and interfere with the measurement.
• External radiating devices may disturb the measurement.
• Poor signal quality may lead to inappropriate BIS values.
27.3 BIS Parameters
Single side BIS monitoring provides the following parameters:
Parameter Description
BIS
(Bispectral Index )
The BIS numeric reflects the patient’s level of consciousness. It ranges from 100 for wide
awake to 0 in the absence of brain activity.
100: the patient is wide awake.
70: the patient is underdosed but still unlikely to become aware.
60: the patient is under general anesthesia and loses consciousness.
40: the patient is overdosed and in deep hypnosis.
0: the EEG is a flat line. The patient has no electrical brain activity.
SQI
(Signal Quality Index)
The SQI numeric reflects signal quality and provides information about the reliability of
the BIS, SEF, TP, and SR numerics during the last minute. The greater the SQI value, the
better signal quality.
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