• A Fudickar, B Bein, M Steinfath, D Voss, G Serocki, W Jeckström, and P Ambrosch.
• Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
• Anaesthesia. 2011 Oct 1;66(10):936-41.

AbstractThis study investigates the incidence of clinically relevant asymmetry in bispectral index readings from different sides of the skull (using two monitors) during ear-nose-throat surgery in 42 adults and 46 children. A unilateral increase or decrease > 10% from baseline was defined as an 'asymmetry'. Asymmetry followed by movement after stimulation was defined as a 'clinically relevant asymmetry'. Asymmetry occurred in 39 out of 42 adults (93%) and in 20 out of 46 children (44%) during surgery and in 24 out of 42 adults (57%) and in 17 out of 46 children (37%) during recovery. Clinically relevant asymmetry was observed in 5 out of 42 adults (12%) and 6 out of 46 children (13%). The incidence of asymmetry was higher in adults during surgery (p = 0.0002). In conclusion, clinically relevant bispectral index asymmetry has been observed in > 10% of paediatric and adult anaesthesia and may have clinical implications. You can respond to this article at http://www.anaesthesiacorrespondence.com.© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

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