Discussion
SQI
DECUBITUS, BROWN
When the sensor’s placement is in the surgical field, the manufacturer does not recommend the standard sensor position for BIS-guided anesthesia [The BIS sensor’s post-auricular position has been described and studied by Akavipat and colleagues [In Dubey et al. study, BIS sensor placement at the supralabial site can be used as an alternative to the frontal placement in scenarios where the frontal position is the surgical site or is inaccessible during the maintenance of general anesthesia as in neurosurgery with particular emphasis on skin preparation and proper positioning of BIS electrodes to improve the signal quality [In our investigation, to reduce the risk of positioning artifacts and achieve the best recordings, we chose to have a stronger concordance and safety monitoring of the depth of anesthesia when employing two sensors in the same patient undergoing lateral decubitus procedures. Overall, the alternate post-auricular posture and the traditional frontal position do not always meet BIS values. Although there was a significant correlation between the positions of the two sensors (r = 0.607), the Bland-Altman analysis showed a little mean difference (-1.8), and only 4.3% of the readings over the anesthetic maintenance period were outside the range of agreement, which is a significantly low limit of agreement (9.0/- 12.5). It may be clinically appropriate based on clinical values and correlation. Therefore, if the operating field prevents using the normal position during the anesthetic maintenance phase, it is possible to employ the post-auricular position as a backup. SQI evaluates the EEG signal’s quality after acquisition (0-100%). SQI is greater than 80, ensuring high-quality data [EEG artifacts caused by facial muscle EMG activity can significantly lower the BIS score [Additionally, much research looked at the sensor’s location in the occipital position. A case study by Hemmerling and associates [Another study by Brown et al. [This study is limited by relatively small sample size and being a single center study. Further studies are needed in different types of surgeries.