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Decrease in bispectral index prior to cardiovascular collapse during C aesarean sections
Author(s) -
KIM J. Y.,
KIM K. W.,
CHO C. S.,
KIM J. H.,
LEE SI.,
KIM KT.,
PARK J. S.,
KIM J. W.,
CHOE W. J.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12203
Subject(s) - medicine , bispectral index , index (typography) , anesthesia , obstetrics , world wide web , sedation , computer science
We report a case of significant reduction in bispectral index ( BIS ) associated with suspected amniotic fluid embolism ( AFE ) that occurred prior to change in haemodynamic variables. The patient was a 29‐year‐old nulliparous, who was admitted for C aesarean section under general anaesthesia in the 33rd week of pregnancy. After the baby was born, the BIS value suddenly decreased to 0, with suppression ratio of 100. One minute later, saturation decreased abruptly to 85%, end‐tidal carbon dioxide ( EtCO 2 ) decreased to 5 mmHg, peak inspiratory pressure increased to 35 cm H 2 O , and non‐invasive blood pressure ( BP ) failed to obtain a reading. After administration of vasoactive drugs, the systolic BP was maintained at 100 mmHg or higher, the BIS value rose to 10–20, and the EtCO 2 increased to 24–33 mmHg. In this case, the BIS monitoring may provide an earlier warning of impending cardiovascular collapse in the case of AFE .